Gi-Young Ko

University of Ulsan, Urusan, Ulsan, South Korea

Are you Gi-Young Ko?

Claim your profile

Publications (148)365.59 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE. The purpose of this article is to evaluate the clinical effectiveness of trans-catheter arterial embolization (TAE) with N-butyl-2-cyanoacrylate (NBCA), with or without other embolic materials for acute nonvariceal gastrointestinal tract bleeding, and to determine the factors associated with clinical outcomes. MATERIALS AND METHODS. TAE using NBCA only or in conjunction with other materials was performed for 102 patients (80 male and 22 female patients; mean age, 61.3 years) with acute nonvariceal gastrointestinal tract bleeding. Technical success, clinical success, and clinical factors, including age, sex, bleeding tendency, endoscopic attempts at hemostasis, number of transfusions, and bleeding causes (i.e., cancer vs noncancer), were retrospectively evaluated. Univariate and multivariable logistic regression analyses were performed to evaluate clinical factors and their ability to predict patient outcomes. Survival curves were obtained using Kaplan-Meier analyses and log-rank tests. RESULTS. There were 36 patients with cancer-related bleeding and 66 with non-cancer-related bleeding. Overall technical and clinical success rates were 100% (102/102) and 76.5% (78/102), respectively. Procedure-related complications included bowel infarction, which was noted in two patients. Recurrent bleeding and bleeding-related 30-day mortality rates were 15.7% (16/102) and 8.8% (9/102), respectively. Cancer-related bleeding increased clinical failure significantly (p = 0.003) and bleeding-related 30-day mortality with marginal significance (p = 0.05). Overall survival was poorer in patients with cancer-related bleeding. CONCLUSION. TAE with NBCA with or without other embolic agents showed high technical and clinical effectiveness in the management of acute nonvariceal gastrointestinal tract bleeding. Cancer-related bleeding was the only factor related to clinical failure, and possibly related to bleeding-related 30-day mortality.
    AJR. American journal of roentgenology. 03/2015; 204(3):662-8.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The present study aimed to evaluate the risk factors and the role of graft material in the development of an acute phase systemic inflammatory response, and the clinical outcome in patients who undergo endovascular aneurysm repair (EVAR) or open surgical repair (OSR) of an abdominal aortic aneurysm (AAA). We retrospectively evaluated the risk factors and the role of graft material in an increased risk of developing systemic inflammatory response syndrome (SIRS), and the clinical outcome in patients who underwent EVAR or OSR of an AAA. A total of 308 consecutive patients who underwent AAA repair were included; 178 received EVAR and 130 received OSR. There was no significant difference in the incidence of SIRS between EVAR patients and OSR patients. Regardless of treatment modality, SIRS was observed more frequently in patients treated with woven polyester grafts. Postoperative hospitalization was significantly prolonged in patients that experienced SIRS. In multivariate analyses, the initial white blood cell count (P = 0.001) and the use of woven polyester grafts (P = 0.005) were significantly associated with an increased risk of developing SIRS in patients who underwent EVAR. By contrast, the use of woven polyester grafts was the only factor associated with an increased risk of developing SIRS in patients who underwent OSR, although this was not statistically significant (P = 0.052). The current study shows that the graft composition plays a primordial role in the development of SIRS, and it leads to prolonged hospitalization in both EVAR and OSR patients.
    Annals of surgical treatment and research. 01/2015; 88(1):21-7.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) using N-butyl cyanoacrylate (NBCA) for the treatment of active postpartum hemorrhage (PPH) and compare the efficacy of NBCA with gelatin sponge particles. From January 2004 to September 2013, 26 patients with PPH underwent TAE using NBCA as the primary embolic material. All patients were actively bleeding, and 12 (46.2%) had coagulopathy. TAE was performed using 1:2-1:4 mixtures of NBCA and ethiodized oil with or without use of a coil or gelatin sponge. To compare the efficacy of NBCA with conventional embolic material, 50 patients with active bleeding who underwent TAE using gelatin sponge were also analyzed. Angiograms demonstrated pseudoaneurysm or extravasation or both. The technical and clinical success rates were 100% and 92.3% (24 of 26 patients), respectively, for NBCA and 98% and 86.0% (43 of 50 patients), respectively, for gelatin sponge. In the NBCA group, one patient recovered with conservative management, and the other patient died because of multiorgan dysfunction. There were no major or minor procedure-related complications. TAE using NBCA as the primary embolic agent is an effective method for treating PPH with extravasation or pseudoaneurysm; NBCA is comparable to gelatin sponge particles. TAE using NBCA seems to fill pseudoaneurysms and make devascularization more effective than using gelatin sponge. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.
    Journal of vascular and interventional radiology: JVIR 11/2014; · 1.81 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A double stent system (covered stent in uncovered stent) was designed to provide long-term patency without tumor ingrowth or stent-related complications, such as stent migration, cholecystitis, or pancreatitis.
    Acta Radiologica 09/2014; · 1.35 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although dysfunctional radiocephalic arteriovenous fistulas (RCAVFs) are typically treated surgically, the endovascular approach is also considered suitable. The aim of this retrospective study was to compare the cumulative patency rates following surgical and endovascular salvaging of dysfunctional RCAVFs, and to evaluate whether the maturity of vascular access sites at the time of treatment influenced the outcomes.
    Annals of Vascular Surgery 07/2014; · 1.03 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: ObjectiveTo evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) in patients with infiltrative hepatocellular carcinoma (HCC) and to identify the prognostic factors associated with patient survival.Materials and MethodsFifty two patients who underwent TACE for infiltrative HCC were evaluated between 2007 and 2010. The maximum diameter of the tumors ranged from 7 cm to 22 cm (median 15 cm). Of 46 infiltrative HCC patients with portal vein tumor thrombosis, 32 patients received adjuvant radiation therapy for portal vein tumor thrombosis after TACE.ResultsThe tumor response by European Association for the Study of the Liver criteria was partial in 18%, stable in 47%, and progressive in 35% of the patients. The median survival time was 5.7 months (Kaplan-Meier analysis). The survival rates were 48% at six months, 25% at one year, and 12% at two years. In the multivariable Cox regression analysis, Child-Pugh class (p = 0.02), adjuvant radiotherapy (p = 0.003) and tumor response after TACE (p = 0.004) were significant factors associated with patient survival. Major complications occurred in nine patients. The major complication rate was significantly higher in patients with Child-Pugh B than in patients with Child-Pugh A (p = 0.049, χ2 test).ConclusionTranscatheter arterial chemoembolization can be a safe treatment option in infiltrative HCC patients with Child Pugh class A. Child Pugh class A, radiotherapy for portal vein tumor thrombosis after TACE and tumor response are good prognostic factors for an increased survival after TACE in patients with infiltrative HCCs.
    Korean journal of radiology: official journal of the Korean Radiological Society 07/2014; 15(4):464-71. · 1.32 Impact Factor
    This article is viewable in ResearchGate's enriched format
  • [Show abstract] [Hide abstract]
    ABSTRACT: ObjectiveTo evaluate the safety and efficacy of transarterial nephrectomy, i.e., complete renal artery embolization, as an alternative to surgical nephrectomy.Materials and MethodsThis retrospective study included 11 patients who underwent transarterial nephrectomy due to a high risk of surgical nephrectomy or their refusal to undergo surgery during the period from April 2002 to February 2013. Medical records and radiographic images were reviewed retrospectively to collect information regarding underlying etiologies, clinical presentations and embolization outcomes.ResultsThe underlying etiologies for transarterial nephrectomy included recurrent hematuria (chronic transplant rejection [n = 3], arteriovenous malformation or fistula [n = 3], angiomyolipoma [n = 1], or end-stage renal disease [n = 1]), inoperable renal or ureteral injury (n = 2), and ectopic kidney with urinary incontinence (n = 1). The technical success rate was 100%, while clinical success was achieved in eight patients (72.7%). Subsequent surgical nephrectomy was required for three patients due to an incomplete nephrectomy effect (n = 2) or necrotic pyelonephritis (n = 1). Procedure-related complications were post-infarction syndrome in one patient and necrotic pyelonephritis in another patient. Of four patients with follow-up CT, four showed renal atrophy and two showed partial renal enhancement. No patient developed a procedure-related hypertension.ConclusionTransarterial nephrectomy may be a safe and effective alternative to surgical nephrectomy in patients with high operative risks.
    Korean journal of radiology: official journal of the Korean Radiological Society 07/2014; 15(4):472-80. · 1.32 Impact Factor
    This article is viewable in ResearchGate's enriched format
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To assess the safety and efficacy of transcatheter arterial embolization (TAE) for the management of secondary postpartum hemorrhage (PPH) and to determine the factors associated with the clinical outcomes.
    Journal of vascular and interventional radiology: JVIR 06/2014; · 1.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To evaluate the overall and cumulative incidence, degree, interval change, and predictors of hepatic arterial injury (HAI) after cisplatin and gelfoam-based, transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) Methods: A total of 205 HCC patients who underwent three or more sessions of TACE without additional surgical or local treatment, were included. HAI was evaluated at each segment of the hepatic artery using a three-grade scale: 1(slight wall irregularity); 2(overt stenosis); and 3(occlusion). HAI interval change was categorized into three groups: progression; stable-state; and improvement. Cumulative incidence of HAI was analyzed using Kaplan-Meier method, and predictors of HAI (patient age, sex, portal vein thrombosis, and Child-Pugh classification) were analyzed by univariate logistic regression. Results: HAI occurred in 50 of 205 study patients (24.4%). The cumulative incidence of HAI during five sessions of TACE was 16.0%(95%CI,10.21-21.77), 52.1%(95%CI,37.83-66.29) during 10 sessions, and 68.0%(95%CI,67.62-88.46) during 15 sessions. Initial HAI was interpreted as grades 1, 2, and 3 in 11(22.0%), 17(34.0%), and 22(44.0%) patients, respectively. When the interval change was assessed in 48 patients with available follow-up TACE, 40(83.3%) were included in the progression, two(4.2%) in the stable-state, and six(12.5%) in the improvement groups. The univariate analysis used to determine the predictors of HAI revealed no significant predictors. Conclusions: 3 or more sessions of TACE, the incidence of HAI is 24%. Increasing TACE causes increased incidence of HAI. The initial presentation was most commonly grade 3, and 12.5% of the patients with HAI showed improvement of the HAI grade during follow-up TACE.
    British Journal of Radiology 06/2014; 87(1041):20140054. · 1.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES:To compare the effectiveness of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) for treating small (≤2 cm) hepatocellular carcinomas (HCCs).METHODS:This retrospective study consisted of 287 patients (mean age, 57.1 years; age range, 29-84 years; 221 men, 66 women; 73.5% with HBV; 100% with liver cirrhosis) with Barcelona Clinic Liver Cancer very early-stage HCC (≤2 cm single HCC) who were initially treated with TACE (n=122) or RFA (n=165). The primary study end point was overall patient survival. Secondary study end points were time to progression and tumor response.RESULTS:The RFA and TACE groups were well balanced in terms of baseline variables. The two groups did not differ significantly in overall survival (P=0.079) or major complication (P>0.999) rates. The respective cumulative survival rates at 1, 3, 5, and 8 years were 97.6, 86.7, 74.5, and 60.0% for RFA and 93.4, 75.4, 63.1, and 51.1% for TACE. Their objective tumor regression (complete or partial response) rates were 100% (165/165) and 95.9% (117/122), respectively (P=0.013). The median times to progression for RFA and TACE were 27.0±3.8 (95% confidence intervals (CIs): 19.6-34.4) and 18.0±2.9 (95% CIs: 12.2-23.8) months, respectively. RFA yielded a significantly longer time to progression (P=0.034).CONCLUSIONS:TACE may be a viable alternative treatment for ≤2 cm HCCs when RFA is not feasible.Am J Gastroenterol advance online publication, 17 June 2014; doi:10.1038/ajg.2014.152.
    The American Journal of Gastroenterology 06/2014; · 9.21 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To evaluate the efficacy and safety of transfemoral liver biopsy using a Quick-Core biopsy needle in selected living donor liver transplantation (LDLT) recipients. Materials & methods: Eight LDLT recipients underwent nine sessions of transfemoral liver biopsy. Six patients had received modified-right-lobe LDLT and two patients had received dual-left-lobes LDLT. Indications for transfemoral liver biopsy were patients with acute HV angle relative to the IVC on the coronal plane and/or patients with thin (<10mm) liver parenchyma surrounding a HV to be biopsied on enhanced computed tomography. Under fluoroscopic guidance, the right inferior HV in the modified-right-lobe or the left HV in the right-sided left lobe with cranial orientation was negotiated using a 5-F catheter via the common femoral vein. Then, a stiffening cannula was introduced into the HV over a stiff guide wire. Needle passage was then performed with an 18- or 19-G Quick-Core biopsy needle. Results: Technical success was achieved in all sessions without major complications. The median number of needle passages was four (range, 2-6). The median total length of obtained liver specimens in each session was 44 mm (range, 24-75 mm). The median number of portal tracts was 18 (range, 10-29) and the obtained liver specimens were adequate for histological diagnosis in all sessions. Conclusion: Transfemoral liver biopsy using a Quick-Core biopsy needle is an effective and safe alternative for obtaining a liver specimen when standard transjugular liver biopsy is not feasible because of an unfavorable HV angle relative to the IVC and/or thin liver parenchyma surrounding a HV. Liver Transpl , 2014. © 2014 AASLD.
    Liver Transplantation 06/2014; · 3.79 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: ObjectiveTo evaluate the safety and clinical efficacy of transcatheter uterine artery embolization (UAE) for post-myomectomy hemorrhage.Materials and MethodsWe identified eight female patients (age ranged from 29 to 51 years and with a median age of 37) in two regional hospitals who suffered from post-myomectomy hemorrhage requiring UAE during the time period from 2004 to 2012. A retrospective review of the patients' clinical data, uterine artery angiographic findings, embolization details, and clinical outcomes was conducted.ResultsThe pelvic angiography findings were as follows: hypervascular staining without bleeding focus (n = 5); active contrast extravasation from the uterine artery (n = 2); and pseudoaneurysm in the uterus (n = 1). Gelatin sponge particle was used in bilateral uterine arteries of all eight patients, acting as an empirical or therapeutic embolization agent for the various angiographic findings. N-butyl-2-cyanoacrylate was administered to the target bleeding uterine arteries in the two patients with active contrast extravasation. Technical and clinical success were achieved in all patients (100%) with bleeding cessation and no further related surgical intervention or embolization procedure was required for hemorrhage control. Uterine artery dissection occurred in one patient as a minor complication. Normal menstrual cycles were restored in all patients.ConclusionUterine artery embolization is a safe, minimally invasive, and effective management option for controlling post-myomectomy hemorrhage without the need for hysterectomy.
    Korean journal of radiology: official journal of the Korean Radiological Society 05/2014; 15(3):356-63. · 1.32 Impact Factor
    This article is viewable in ResearchGate's enriched format
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patent portal vein (PV) and adequate portal inflow is essential for successful living donor liver transplantation (LDLT). In extensive portal vein thrombosis (PVT) patients, however, complete PV thrombectomy is not feasible particularly at intrapancreatic portion, and subsequently portal flow steal through preexisting sizable collaterals or rethrombosis can occur. To overcome those problems, we introduced interruption of sizable collaterals and intraoperative cine-portogram (IOP), which is useful for diagnosis and treatment of residual PVT and sizable collaterals.
    Transplantation 04/2014; 97 Suppl 8:S23-30. · 3.78 Impact Factor
  • Gi-Young Ko, Kyu-Bo Sung
    [Show abstract] [Hide abstract]
    ABSTRACT: Although endoscopic treatment has become the first choice to treat biliary complications, percutaneous transhepatic treatment still has important roles to treat biliary stricture or leak after living donor liver transplantation. This study reviewed a total of 527 recipients who had undergone percutaneous transhepatic treatment to treat biliary stricture (n=498) and leaks (n=29). Percutaneous transhepatic treatment included percutaneous transhepatic biliary drainage, perihepatic biloma drainage, balloon dilation of biliary stricture, and drainage catheter interposition or retrievable covered stent placement across a stricture or leak segment. Clinical success was achieved in 440 (88.4%) recipients with biliary stricture and 19 (65.5%) recipients with bile leaks. Percutaneous transhepatic treatment seems to be an effective alternative for treating biliary complications resistant to or inaccessible by endoscopic treatment.
    Transplantation 04/2014; 97 Suppl 8:S43-6. · 3.78 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To evaluate the technical feasibility and clinical outcome of bilateral uterine artery embolization (UAE) as a first-line therapeutic option for bleeding uterine arteriovenous malformation (AVM). Materials and Methods: Between 2002 and 2012, 19 patients were diagnosed with acquired uterine AVM clinically and through imaging studies. The clinical characteristics, angiographic features, technical success rate of embolization, procedure-related complications, imaging, and clinical follow-up data were assessed. Clinical success was defined as immediate symptomatic resolution with disappearance of vascular abnormality on subsequent imaging studies. Results: A total of 20 bilateral UAE, with or without embolization of extra-uterine feeders, were performed as the first-line treatment. Technical and clinical success rate was 90.0% (18/20) and 89.5% (17/19), respectively. Embolization was incomplete in two patients who had residual extra-uterine fine feeders to the AVM or a procedure- related complication (ruptured uterine artery); the former showed slow regression of the vascular malformation during the observation period, while the latter underwent a successful second bilateral UAE. Immediate clinical success was achieved in the remaining 17 patients after a single session and no recurrence of bleeding was found. Recovery to normal menstrual cycle was seen in all 17 patients with clinical success within one or two months, two of whom subsequently had uneventful intrauterine pregnancies carried to term. Conclusion: Bilateral UAE is a safe and effective first-line therapeutic option for the management of bleeding uterine AVMs. However, incomplete embolization due to unembolizable feeders or difficult access into the uterine artery may lead to suboptimal treatment.
    Yonsei medical journal 03/2014; 55(2):367-73. · 0.77 Impact Factor
    This article is viewable in ResearchGate's enriched format
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although the use of polytetrafluoroethylene (PTFE)-covered biliary stents has proven to be feasible for the treatment of benign and malignant biliary disease, less is known regarding the outcomes of percutaneous placement of a covered stent in patients with malignant duodenobiliary obstruction. To investigate the technical and clinical efficacy of the percutaneous placement of a PTFE-covered biliary stent in patients with malignant duodenobiliary obstruction. From April 2007 to September 2012, the medical records of 45 consecutive patients with malignant duodenobiliary obstruction were retrospectively reviewed. All percutaneous biliary stent deployment was performed using PTFE-covered stents, whereas duodenal stent insertion was performed either fluoroscopically or endoscopically using covered or uncovered stents. Biliary stent deployment was technically successful in all patients. None of the stents migrated after deployment. Procedure-related minor complications, including self-limiting hemobilia, occurred in three (7%) patients. Successful internal drainage was achieved in 39 (87%) of the 45 patients. The median survival time after biliary stent placement was 62 days (95% confidence interval, 8-116 days), and the cumulative stent patency rates at 1, 3, 6, and 12 months were 96%, 92%, 75%, and 38%, respectively. The causes of biliary stent dysfunction included stent occlusion caused by a subsequently inserted duodenal stent (n = 7), food impaction (n = 3), and sludge incrustation (n = 1). One patient developed acute cholecystitis 131 days after biliary stent placement and underwent percutaneous transhepatic gallbladder drainage. Percutaneous insertion of a PTFE-covered stent is a safe and effective method for palliative treatment of patients with malignant duodenobiliary obstruction. If possible, subsequent biliary stent insertion is preferable in order to prevent possible biliary stent dysfunction caused by subsequent insertion of a duodenal stent.
    Acta Radiologica 02/2014; · 1.35 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The meso-Rex shunt is used to safely and effectively treat patients with portal hypertension due to extrahepatic portal vein obstruction. In the standard meso-Rex shunt technique, the patient's own internal jugular vein is used as a vascular autograft. Inevitably, such a procedure requires neck exploration and sacrifice of the internal jugular vein. Here, we present a case of a 20-year-old man with idiopathic extrahepatic portal vein obstruction, who was treated with a new technique of transposition of the coronary vein, which is enlarged in most cases of portal hypertension, as an alternative to the standard meso-Rex shunt technique. The transposition of the coronary vein into the Rex recessus is more efficient and less invasive than harvesting an autologous vein graft. Therefore, this technique simplifies the procedure and should be used when possible.
    Annals of surgical treatment and research. 02/2014; 86(2):105-8.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the safety and efficacy of unilateral covered stent placement in patients with malignant superior vena cava (SVC) syndrome. Between October 2008 and November 2012, expanded polytetrafluoroethylene-covered stent placement for malignant SVC syndrome was performed in 40 consecutive patients (35 men and five women; mean age, 61.4 years; range, 35-81 years). All covered stents were unilaterally placed within the SVC or across the venous confluence when needed to relieve venous obstruction and prevent tumor overgrowth, regardless of patency of contralateral brachiocephalic veins. Stent placement was technically successful in all patients. There were no major complications. Of the 37 patients symptomatic prior to stent placement, 34 (92%) experienced complete symptomatic relief 1-8 days after stent placement. Of the 29 patients who underwent covered stent placement across the venous confluence, nine patients had patent contralateral brachiocephalic veins prior to stent placement. However, no sign of SVC obstruction or contralateral upper extremity venous thrombosis was observed during the follow-up period. Kaplan-Meier analysis revealed median patient survival of 163 days. Stent occlusion occurred in four (10%) of 40 patents. Cumulative stent patency rates at 1, 3, 6, and 12 months were 95%, 92%, 86%, and 86%, respectively. Unilateral covered stent placement appears to be a safe and effective method for treating malignant SVC syndrome, despite the location of SVC occlusion.
    Korean journal of radiology: official journal of the Korean Radiological Society 01/2014; 15(1):87-94. · 1.32 Impact Factor
    This article is viewable in ResearchGate's enriched format
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to evaluate retrospectively the results of PTA for late-onset PV complications after pediatric LDLT and to assess whether a meso-Rex shunt is a viable option for treating restenosis of the PV after PTA in selected cases. Seventy-five children who underwent adult-to-child LDLT were included in this study, and there were six late-onset PV complications (8.0%). The initial therapeutic approach was PTA, with or without stent: PTA with balloon dilation for three children, PTA with stent placement for one child, and failure to cannulate the occluded PV for two children. A meso-Rex shunt was performed in the two children after failed PTA: One suffered complete obstruction of the main PV, and the other, restenosis with total thrombosis after PTA with stent. The PTA was a technical and clinical success in four with PV stenosis of the six patients (66.7%), and successful application of a meso-Rex shunt in the other two children resulted in restoration of PV flow. In conclusion, PTA is a safe and effective procedure for treating late-onset PV stenosis after pediatric LDLT. However, in growing pediatric recipients with restenosis of the PV after PTA or chronic PV thrombosis, a meso-Rex shunt may be a better choice for late-onset PV complications.
    Pediatric Transplantation 12/2013; · 1.63 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE The purpose of this study is to investigate radiologic and histologic features of biliary intraductal metastasis from advanced gastric cancer in 24 patients with biliary obstruction and clinical outcomes after metallic stent placement. METHOD AND MATERIALS Patient papulation: This retrospective study was approved by Institutional Review Board of our institution and written informed consent was waived. Between August 2003 and August 2012, 24 consecutive patients with obstructive jaundice related to biliary intraductal metastasis from advanced gastric cancers were enrolled. Imaging Methods and Diagnosis PTBD, Biliary Biopsy, and Pathologic Analysis Metallic Stent Placement Endpoints of stent placement and Statistical analysis RESULTS Imaging and pathologic Characteristics: uniform concentric linear (n=17) or band-like (n=7) enhanced wall thickening. 20 (83.3%) had cystic ductal lesions contiguous with the intraductal lesions. The level of biliary obstruction was hilar in 13 (54.2%) patients and non-hilar in 11 (45.8%). Ninety (79.2%) patients had lymph node metastasis around the biliary system.The submucosal fibrosis was universal feature in all biopsied cases (n=6), regardless of the malignant or atypical cells, and none of the cases shows biliary mucosa disruption by the malignant cells. Outcomes of Metallic Stent Placement: Stent occlusion was observed in four (17%) patients treated with PTBD, in three owing to sludge incrustation and in one owing to tumor overgrowth, 49—278 days (mean, 168 days) after stent placement. Mean stent patency time was 341 days (95% CI 272–410 days) and cumulative stent patency rates at 3, 6, 9, and 12 months were 95%, 88%, 78%, and 62%, respectively CONCLUSION In conclusion, imaging and pathologic characteristics of biliary intraductal metastasis from advanced gastric cancer are uniform enhanced biliary wall thickening, and submucosal malignant cells and fibrosis without any disruption of biliary epithelial layer. Moreover, uncovered metallic stent placement was safe and effective methods for palliative treatment in patients with biliary intraductal metastasis cause by advanced gastric cancer. CLINICAL RELEVANCE/APPLICATION The clinical outcomes after uncovered stent placement and pathologic proof may give an explanation.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013

Publication Stats

1k Citations
365.59 Total Impact Points

Institutions

  • 2003–2014
    • University of Ulsan
      • College of Medicine
      Urusan, Ulsan, South Korea
  • 2002–2014
    • Ulsan University Hospital
      Urusan, Ulsan, South Korea
  • 2006–2013
    • Asan Medical Center
      • • Department of Radiology
      • • Department of Oncology
      Sŏul, Seoul, South Korea
  • 2012
    • Gangneung Asan Hospital
      Sŏul, Seoul, South Korea
    • Hanyang University
      • College of Medicine
      Ansan, Gyeonggi, South Korea
  • 2011
    • University of North Carolina at Chapel Hill
      • Department of Radiology
      Chapel Hill, NC, United States
  • 2010
    • University of California, Los Angeles
      Los Ángeles, California, United States
  • 2008–2010
    • Inje University Paik Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2003–2007
    • Yonsei University Hospital
      Sŏul, Seoul, South Korea