Endoscopic selective biliary stenting and reintervention using metal stents with a slim delivery system in a patient with complexly altered digestive anatomy

2021 ◽  
Author(s):  
Takao Nishikawa ◽  
Junichiro Kamiya ◽  
Dan Takeuchi
Keyword(s):  
Delivery System ◽  
Metal Stents ◽  
Biliary Stenting ◽  
Digestive Anatomy

scholarly journals A comparison of outcomes between a lumen-apposing metal stent with electrocautery-enhanced delivery system and a bi-flanged metal stent for drainage of walled-off pancreatic necrosis

2017 ◽  
Vol 05 (12) ◽  
pp. E1189-E1196 ◽  
Author(s):  
Noor Bekkali ◽  
Manu Nayar ◽  
John Leeds ◽  
Richard Charnley ◽  
Matthew Huggett ◽  
...  
Keyword(s):  
Adverse Events ◽  
Delivery System ◽  
Pancreatic Necrosis ◽  
Clinical Success ◽  
Stent Migration ◽  
Metal Stents ◽  
Procedure Time ◽  
Metal Stent ◽  
End Point ◽  
Significant Difference

Abstract Background and study aims Bi-flanged metal stents (BFMS) have shown promise in the drainage of walled-off pancreatic necrosis (WON), but their placement requires multiple steps and the use of other devices. More recently, a novel device consisting of a combined lumen-apposing metal stent (LAMS) and electrocautery-enhanced delivery system has been introduced. The aim of this study was to compare the placement and outcomes of the two devices. Patients and methods This was a retrospective review of consecutive patients undergoing endoscopic ultrasound-guided placement of BFMS or LAMS for drainage of symptomatic WON. Data from procedures between October 2012 and December 2016 were taken from a prospectively maintained database. We compared technical and clinical success, procedure time, costs, and composite end point of significant events (adverse events, stent migration, additional percutaneous drainage) between BFMS and LAMS. Results 72 consecutive patients underwent placement of BFMS (40 patients, 44 stents) or LAMS (32 patients, 33 stents). Technical success was 91 % for BFMS and 97 % for LAMS. Clinical success was 65 % vs. 78 %, respectively. Median in-room procedure time was significantly shorter in the LAMS group (45 minutes [range 30 – 80]) than in the BFMS group (62.5 minutes [range 35 – 135]; P < 0.001) and fewer direct endoscopic necrosectomies (DEN) were performed (median 1 [0 – 2.0] vs. 2 [0 – 3.7], respectively; P = 0.005). If only inpatients were considered (35 BFMS and 19 LAMS), there was no significant difference in DEN 2 (range 0 – 11) and 2 (range 0 – 8), respectively. The composite end point of 32 % vs. 24 % was not significantly different. Median procedural costs for all patients with successful stent placement for WON treatment was €4427 (range 1630 – 12 926) for BFMS vs. €3500 (range 2509 – 13 393) for LAMS (P = 0.10). Conclusion LAMS was superior to BFMS in terms of procedure time, with comparable adverse events, success, and costs.

Mo1569 Previous Biliary Stenting Is Not Mandatory Before Endoscopic Placement of Duodenal Covered Self Expandable Metal Stents

2014 ◽  
Vol 79 (5) ◽  
pp. AB487
Author(s):  
FéLix Goutorbe ◽  
Olivier Rouquette ◽  
Michel Dapoigny ◽  
Armando Abergel ◽  
Gilles Bommelaer ◽  
...  
Keyword(s):  
Metal Stents ◽  
Biliary Stenting ◽  
Endoscopic Placement

scholarly journals Newer Stents for Unresectable Malignant Distal Biliary Obstruction: Striving for Perfection!

2021 ◽  
Vol 12 (01) ◽  
pp. 059-062
Author(s):  
Jimil Shah ◽  
Surinder Singh Rana
Keyword(s):  
Biliary Drainage ◽  
Biliary Obstruction ◽  
Drug Eluting Stents ◽  
Metal Stents ◽  
Biliary Stenting ◽  
Stent Occlusion ◽  
Endoscopic Biliary Stenting ◽  
Palliative Procedure ◽  
Drug Eluting ◽  
And Migration

AbstractEndoscopic biliary stenting is one of the most commonly used palliative procedure in patients with unresectable malignant distal biliary obstruction. Biliary stenting can be performed with either plastic or metallic stents. Stent occlusion and migration are important limitations of currently available stents. Variety of newer stents with varying designs and stent materials like stents with antimigratory properties, antireflux stents, drug-eluting stents, radioactive stents, and bioabsorbable stents are being developed to overcome the limitations of currently available stents. In this article, we are discussing two articles on the newer stent designs (plastic and metal stents) for biliary drainage in patients with unresectable malignant distal biliary obstruction.

scholarly journals New indications for fully covered lumen-apposing metal stents: biliary stenting to treat post-sphincterotomy bleeding or ampullary stenosis

Endoscopy ◽  
2017 ◽  
Vol 50 (02) ◽  
pp. E36-E37 ◽  
Author(s):  
Gianfranco Donatelli ◽  
Jean-Loup Dumont ◽  
Serge Derhy ◽  
Bruno Meduri ◽  
Stavros Dritsas ◽  
...  
Keyword(s):  
Metal Stents ◽  
Biliary Stenting ◽  
Ampullary Stenosis

Mo1353 Biliary Stenting in Patients With Malignant Biliary Obstruction: Comparison of Double Layer, Plastic and Metal Stents

2012 ◽  
Vol 75 (4) ◽  
pp. AB398
Author(s):  
Saleh Elwir ◽  
Joshua Veith ◽  
Kaveh Sharzehi ◽  
Matthew T. Moyer ◽  
Charles E. Dye ◽  
...  
Keyword(s):  
Double Layer ◽  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Metal Stents ◽  
Biliary Stenting

scholarly journals Antegrade biliary stenting for obstructive jaundice

2019 ◽  
Vol 24 (2) ◽  
pp. 25-35
Author(s):  
A. V. Andreev ◽  
V. M. Durleshter ◽  
A. I. Leveshko ◽  
S. A. Gabriel ◽  
E. V. Tokarenko
Keyword(s):  
Obstructive Jaundice ◽  
Bare Metal Stents ◽  
Metallic Stents ◽  
Metal Stents ◽  
Covered Stents ◽  
Bare Metal ◽  
Biliary Stenting ◽  
Malignant Obstructive Jaundice ◽  
Invasive Approach ◽  
Expandable Metallic Stents

Objective. To determine the role bile duct stenting with self-expandable metallic stents in the treatment of malignant obstructive jaundice. Material and methods. Eight-year experience of palliative antegrade stenting with self-expandable metallic stents was analyzed. There were 218 patients with malignant obstructive jaundice. Distal and proximal obstruction was diagnosed in 118 (54%) and 100 (46%) patients, respectively. We have used self-expandable metallic covered, partially covered and bare-metal stents with diameter of 10, 8 and 6 mm and length of 40, 60 and 80 mm. Results. Technical success in antegrade two-stage installation of self-expandable stents have been achieved in 208 (99%) patients. There were 230 deployed self-expandable metallic stents. Seven (3%) patients underwent simultaneous stenting of right and left hepatic ducts and confluence area with bare-metal stents. Stenting of right or left hepatic ducts and confluence area with partially covered stents was carried out in 34 (16%) patients. Other 59 (27%) patients with proximal biliary obstruction and no separation of lobar bile ducts underwent stenting with 27 partially covered and 31 covered stents. Distal obstruction was managed by using of covered stents as a rule (63%). Complications after antegrade biliary stenting occurred in 29 (13%) patients. Conclusion. Antegrade biliary stenting with metallic self-expandable stents is effective and minimally invasive approach. Moreover, it is comparable with conventional palliative interventions aimed at bile outflow recovery.

scholarly journals An audit of percutaneous biliary stenting for the palliation of pancreatic cancer: Results, post-procedural survival period, and comparison of plastic and mental stents

2002 ◽  
Vol 6 (2) ◽  
pp. 18-20
Author(s):  
M. J. Marais ◽  
C. S. De Vries
Keyword(s):  
Cost Effective ◽  
Survival Period ◽  
Plastic Stents ◽  
Metal Stents ◽  
High Morbidity ◽  
Biliary Stenting ◽  
Biliary Stents ◽  
Surgical Bypass ◽  
Head Of The Pancreas ◽  
Surgical Options

The purpose of this retrospective study was to assess the patient survival period after palliative biliary stenting and to compare different kinds of stents used. During a 27-month period, 60 patients received palliative percutaneous biliary stents for obstructive jaundice due to carcinoma of the head of the pancreas. During the first procedure 17 patients received (metal) Wall stents (mean age 59.8 years, range 32 - 77 years), and 43 patients received (plastic) Carey Coons stents (mean age 62.3 years, range 31 - 87 years). In 12 patients the stent had to be replaced due to complications and 1 patient had a second replacement. All replacement stents were plastic except in 2 cases. Two out of 17 (11.7%) metal stents and 10 out of 43 (23.2%) plastic stents had to be replaced. The median post-procedural survival period was determined between the date of procedure and the date of death. There was a marked clinical improvement of jaundice in all patients with their follow-up within a few days. More plastic stents were replaced. The average post-procedural survival period for 41 patients was 85.6 days, which is on par with internationally accepted survival periods. The most cost-effective biliary stent must be used for palliation because of the very short survival rate of this disease. For patients with no surgical options this procedure yields excellent results in comparison with the high morbidity and mortality rates of palliative surgical bypass procedures.

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