A Case Report of Tumor Ingrowth in Metalic Stent of Bile Duct; The Usage of Argon Plasma Coagulation Therapy

Tadashi Matsuhisa, Khor Lee Wee, Akihiko Kataoka, Shunji Yamada, Masahiko Koike and Yoshinobu Akasaka

Department of Surgery, Kohnan Hospital

A 53-year-old woman with ascending colon carcinoma and cholecystolithiasis underwent resection of the ascending colon and gallbladder. Postoperative liver metastases necessitated transcatheter arterial embolization, intraarterial chemotherapy, percutaneous microwave coagulation therapy, left liver lobectomy and percutaneous ethanol injection therapy. A base metallic stent was inserted for bile duct stenosis at the hepatic porta. At 5.25 years after this treatment, she suffered a high fever and jaundice due to stent obstruction diagnosed in endoscopic retrograde cholangiography. Via percutaneous transhepatic cholangiodranage, the side wall of the stent was partially broken with a balloon catheter and intrabile duct fiberscopy showed the stent to be completely obstructed by tumor ingrowth. The stent was reopened with argon plasma coagulation therapy (probe: 1.5mm; power: 35 W; flow: 1.01/min). A covered stent was inserted through the broken wall of the first stent. At 161 days after this second treatment percutaneous transhepatic cholangiodranage was performed for obstructive jaundice.

Key words
stent in bileduct, tumor ingrowth in stent, argon plasma coagulation therapy

Reprint requests
Tadashi Matsuhisa Department of Surgery, Kohnan Hospital 1-6 Hiragishi Toyohira, Sapporo, 062-0931 JAPAN

Accepted
May 29, 2002

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