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Biliary stenting

Case 1 : Patient with hilar cholangiocarcinoma presented with obstructive jaundice. There was a tight stricture in common hepatic duct which could not be stented endoscopically. Hence procedure was done percutaneously. 
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ERCP shows tight stricture of Common Hepatic Duct.(CHD) There is dilatation of intrahepatic biliary radicles. Common bile duct is normal in calibre . 
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 Through endoscopy, stenting of the stricture in CHD was not successful.Plastic stent was deployed percutaneously across the CHD stricture with its proximal tip in right hepatic duct  and distal tip in duodenum(Black arrow) .

Contrast is seen flowing freely into duodenum(white arrow)  

 

Case 2 : Patient of Carcinoma Pancreas presented  with obstructive jaundice as  metastatic lymph nodes were compressing distal CBD

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Occlusion of distal common bile duct(CBD) is seen in a patient of carcinoma of pancreas. 
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As a first step, percutaneous transhepatic biliary drainage was performed. After 48 hours, CBD occlusion could be crossed .Metal stent was deployed across the CBD stricture ( black arrow) .

External biliary drainage catheter is seen .

 

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