scholarly journals Implanting metallic stent for malignant stricture of the afferent loop caused by direct invasion of pancreatic cancer

2019 ◽  
Vol 94 (1) ◽  
pp. 87-89
Author(s):  
Mariko Nakatani ◽  
Tsunao Imamura ◽  
Yoshiki Sato ◽  
Yuji Urasaki ◽  
Tetsuo Tamura ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Metallic Stent ◽  
Afferent Loop ◽  
Direct Invasion ◽  
Malignant Stricture

scholarly journals Rendezvous for afferent limb syndrome

2020 ◽  
Vol 2 (9) ◽  
pp. 01-04
Author(s):  
Ivan Mendez
Keyword(s):  
Pancreatic Cancer ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Stent Placement ◽  
Whipple Procedure ◽  
Metallic Stent ◽  
Biliary Anatomy ◽  
Endoscopic Retrograde ◽  
Afferent Limb ◽  
Rendezvous Technique ◽  
Metallic Stent Placement

Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgical alterations in the normal biliary anatomy is technically challenging. We describe the case of a 73-year-old patient with an afferent limb syndrome secondary to a Whipple procedure for pancreatic cancer, in which a percutaneous rendezvous technique assisted in the endoscopic metallic stent placement with favorable outcome.

scholarly journals Novel risk factors for recurrent biliary obstruction and pancreatitis after metallic stent placement in pancreatic cancer

2020 ◽  
Vol 08 (11) ◽  
pp. E1603-E1610
Author(s):  
Tsuyoshi Takeda ◽  
Takashi Sasaki ◽  
Takafumi Mie ◽  
Takaaki Furukawa ◽  
Ryo Kanata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Cancer ◽  
Risk Factor ◽  
Biliary Obstruction ◽  
Volume Index ◽  
Metallic Stent ◽  
Sems Placement ◽  
Borderline Resectable ◽  
Pancreatic Volume ◽  
Novel Risk Factors

Abstract Background and study aims Self-expandable metallic stents (SEMS) are now widely used even for patients with borderline resectable (BR) pancreatic cancer (PC), as neoadjuvant therapy has become common. Therefore, we conducted this study to evaluate safety of SEMS placement in the population including BR PC and to explore risk factors for recurrent biliary obstruction (RBO), pancreatitis, and cholecystitis. Patients and methods We retrospectively investigated consecutive patients with PC who received initial SEMS between January 2015 and March 2019. We compared time to RBO (TRBO), causes of RBO, and stent-related adverse events (AEs) according to resectability status. Univariate and multivariate analyses were performed to explore risk factors for TRBO, pancreatitis, and cholecystitis. Results A total of 135 patients were included (BR 31 and unresectable [UR] 104). Stent-related AEs occurred in 39 patients: pancreatitis 14 (mild/moderate/severe 1/6/7), cholecystitis 12, and non-occluding cholangitis 13. TRBO, causes of RBO, and stent-related AEs were not significantly different according to resectability status. Overall rate of RBO was higher in UR PC due to the longer follow-up period. Sharp common bile duct (CBD) angulation was an independent risk factor for short duration of TRBO. High pancreatic volume index and SEMS of high axial force were independent risk factors for pancreatitis, whereas tumor involvement to orifice of cystic duct was the only risk factor for cholecystitis. Conclusions We demonstrated that SEMS can be safely deployed even in patients with BR PC. Sharp CBD angulation and high pancreatic volume index were identified as novel risk factors for RBO and pancreatitis, respectively, after SEMS placement.

scholarly journals Preoperative Biliary Drainage in Cases of Borderline Resectable Pancreatic Cancer Treated with Neoadjuvant Chemotherapy and Surgery

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Tomofumi Tsuboi ◽  
Tamito Sasaki ◽  
Masahiro Serikawa ◽  
Yasutaka Ishii ◽  
Teruo Mouri ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Biliary Drainage ◽  
Preoperative Biliary Drainage ◽  
Metallic Stents ◽  
Plastic Stents ◽  
Complication Rates ◽  
Metallic Stent ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Hospitalization Costs

Objective. To elucidate the optimum preoperative biliary drainage method for patients with pancreatic cancer treated with neoadjuvant chemotherapy (NAC).Material and Methods. From January 2010 through December 2014, 20 patients with borderline resectable pancreatic cancer underwent preoperative biliary drainage and NAC with a plastic or metallic stent and received NAC at Hiroshima University Hospital. We retrospectively analyzed delayed NAC and complication rates due to biliary drainage, effect of stent type on perioperative factors, and hospitalization costs from diagnosis to surgery.Results. There were 11 cases of preoperative biliary drainage with plastic stents and nine metallic stents. The median age was 64.5 years; delayed NAC occurred in 9 cases with plastic stent and 1 case with metallic stent (p=0.01). The complication rates due to biliary drainage were 0% (0/9) with metallic stents and 72.7% (8/11) with plastic stents (p=0.01). Cumulative rates of complications determined with the Kaplan-Meier method on day 90 were 60% with plastic stents and 0% with metallic stents (log-rank test,p=0.012). There were no significant differences between group in perioperative factors or hospitalization costs from diagnosis to surgery.Conclusions. Metallic stent implantation may be effective for preoperative biliary drainage for pancreatic cancer treated with NAC.

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