Usefulness of self‐expandable metal stents for malignant biliary obstruction using a short‐type single‐balloon enteroscope in patients with surgically altered anatomy

2021 ◽  
Author(s):  
Yuki Tanisaka ◽  
Shomei Ryozawa ◽  
Masafumi Mizuide ◽  
Akashi Fujita ◽  
Tomoya Ogawa ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Metal Stents ◽  
Surgically Altered Anatomy ◽  
Single Balloon ◽  
Short Type

scholarly journals Biliary Obstruction: Endoscopic Approaches

2017 ◽  
Vol 34 (04) ◽  
pp. 369-375 ◽  
Author(s):  
Tomas DaVee ◽  
Jeffrey Lee
Keyword(s):  
Pancreatic Cancer ◽  
Biliary Obstruction ◽  
Epigastric Pain ◽  
Surgical Techniques ◽  
Malignant Biliary Obstruction ◽  
Metal Stents ◽  
Biliary Stents ◽  
Term Survival ◽  
Painless Jaundice

AbstractPainless jaundice is a harbinger of malignant biliary obstruction, with the majority of cases due to pancreatic adenocarcinoma. Despite advances in treatment, including improved surgical techniques and neoadjuvant (preoperative) chemotherapy, long-term survival from pancreatic cancer is rare. This lack of significant improvement in outcomes is believed to be due to multiple reasons, including the advanced stage at diagnosis and lack of an adequate biomarker for screening and early detection, prior to the onset of jaundice or epigastric pain. Close attention is required to select appropriate patients for preoperative biliary decompression, and to prevent morbid complications from biliary drainage procedures, such as pancreatitis and cholangitis. Use of small caliber plastic biliary stents during endoscopic retrograde cholangiopancreatography should be minimized, as metal stents have increased area for improved bile flow and a reduced risk of adverse events during neoadjuvant therapy. Efforts are underway by translational scientists, radiologists, oncologists, surgeons, and gastroenterologists to augment lifespan for our patients and to more readily treat this deadly disease. In this review, the authors discuss the rationale and techniques of endoscopic biliary intervention, mainly focusing on malignant biliary obstruction by pancreatic cancer.

A new 12-French plastic stent for unresectable distal malignant biliary obstruction

Endoscopy ◽  
2020 ◽  
Vol 52 (06) ◽  
pp. 474-482
Author(s):  
Pierre H. Deprez ◽  
Tom G. Moreels ◽  
Tarik Aouattah ◽  
Hubert Piessevaux ◽  
Enrique Pérez-Cuadrado-Robles
Keyword(s):  
Adverse Events ◽  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Plastic Stents ◽  
Metal Stents ◽  
Technical Success ◽  
Stent Patency ◽  
Historical Cohort ◽  
Plastic Stent ◽  
Distal Malignant Biliary Obstruction

Background Self-expanding metal stents (SEMSs) are recommended in unresectable distal malignant biliary obstruction. However, problems with dysfunction and migration of these stents are not negligible. We aimed to investigate the effectiveness and safety of a new 12-Fr plastic stent. Methods In an observational, prospective study, all consecutive patients who underwent biliary stenting with the 12-Fr stent were considered (index group). Referent groups were a historical cohort, matched by sex, etiology, and metastatic status, including patients with 10-Fr plastic stents and with fully covered and uncovered SEMSs (FCSEMSs and UCSEMSs). Outcomes were stent patency, recurrent biliary obstruction (RBO), technical success, 30-day mortality and adverse events. A post-procedure examination of removed stents was done. Results 72 patients (median age 66, range 32 – 94 years, 50 % men) were included (24 index, 48 referents). There were no differences in median stent patency time (P = 0.684). RBO was significantly lower with the 12-Fr compared with the 10-Fr profile stent (50 % vs. 81.3 %, P = 0.04), but no difference was found compared with the FCSEMSs (50 % vs. 43.8 %, P = 0.698). Technical success was 100 %, with no differences in 30-day mortality P = 0.105). The adverse events rate was 4.2 % for both groups (index n = 1, referents n = 2). Of 11 removed 12-Fr plastic stents suspected to be dysfunctional, 7 (64 %) were still patent. Conclusions This new 12-Fr plastic stent could be an effective and cheaper alternative to SEMSs in distal malignant biliary obstruction.

scholarly journals Efficacy of the New Double-Layer Stent for Unresectable Distal Malignant Biliary Obstruction: A Single-Center Retrospective Study

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Ken Ito ◽  
Yoshinori Igarashi ◽  
Takahiko Mimura ◽  
Yui Kishimoto ◽  
Yoshinori Kikuchi ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Plastic Stents ◽  
Metal Stents ◽  
Short Life ◽  
First Choice ◽  
Significant Difference ◽  
Distal Malignant Biliary Obstruction ◽  
Short Life Expectancy

Background and Aims. For distal malignant biliary obstruction in cases with short life expectancy, occlusion of plastic stents (PSs) does not usually occur before death, and the application of such a procedure is considered adequate from the viewpoint of cost-effectiveness. Methods and Setting. A new commercially available DLS with side holes, a conventional DLS, and, uncovered self-expanding metal stents (SEMSs) were retrospectively evaluated in patients with jaundice due to unresectable distal malignant biliary obstruction. Results. A total of 64 patients received endoscopic biliary stenting (23 patients with the new DLS, 24 patients with conventional DLS, and 17 patients with uncovered SEMS) from December 2002 to August 2009. Median patency time was found to be 198 days for the new DLS group and 99 days for the conventional DLS group, revealing a significant difference between devices. There was, however, no significant difference in median patency time between the new DLS and the uncovered SEMS (198 days versus 344 days). Conclusion. The new DLS is efficient and safe and may be considered the first choice for unresectable distal malignant obstruction in cases with short life expectancy.

Irradiation stents vs. conventional metal stents for unresectable malignant biliary obstruction: A multicenter trial

2018 ◽  
Vol 68 (5) ◽  
pp. 970-977 ◽  
Author(s):  
Hai-Dong Zhu ◽  
Jin-He Guo ◽  
Ming Huang ◽  
Jian-Song Ji ◽  
Hao Xu ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Multicenter Trial ◽  
Malignant Biliary Obstruction ◽  
Metal Stents
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