scholarly journals Prospective Multicenter Study of the Challenges Inherent in Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction

Gut and Liver ◽  
2018 ◽  
Vol 12 (6) ◽  
pp. 722-727 ◽  
Author(s):  
Min Jae Yang ◽  
Jin Hong Kim ◽  
Jae Chul Hwang ◽  
Byung Moo Yoo ◽  
Sang Hyub Lee ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Stent Placement ◽  
Biliary Obstruction ◽  
Large Cell ◽  
Cell Type ◽  
Prospective Multicenter Study ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction

Percutaneous stent-in-stent placement with large cell-type stents for malignant hilar biliary obstruction

2020 ◽  
pp. 028418512097851
Author(s):  
Gun Ha Kim ◽  
Dong Il Gwon ◽  
Gi-Young Ko ◽  
Jin Hyoung Kim ◽  
Jong Woo Kim ◽  
...  
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Patient Survival ◽  
Large Cell ◽  
Internal Drainage ◽  
Cell Type ◽  
Stent Patency ◽  
Tumor Ingrowth ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction

Background To overcome the technical difficulty of bilateral stent-in-stent placement, large cell-type biliary stents have been developed. However, most of the studies using large cell-type stents were conducted with endoscopic method. Purpose To evaluate the efficacy and safety of percutaneous stent placement with a stent-in-stent method using large cell-type stents in patients with malignant hilar biliary obstruction. Material and Methods From December 2015 and October 2018, 51 patients with malignant hilar biliary obstruction were retrospectively studied. All of the patients underwent bilateral (n=46) or unilateral (n=5) stenting in a T, Y, or X configuration with a stent-in-stent method using large cell-type stents. Technical success, complications, successful internal drainage, stent patency, and patient survival were analyzed. Results A total of 118 stents were successfully placed in 51 patients (100.0%). Three patients had minor complications with self-limiting hemobilia. Major complications were not observed in any patient. Successful internal drainage was achieved in 45 patients (88.2%). Clinical follow-up information until death or the end of the study was available for 50 of 51 patients. The median patient survival was 285.5 days (95% confidence interval [CI] 197–374). Stent dysfunction occurred in 16 patients (35.6%) due to tumor ingrowth (n=9) or tumor ingrowth combined with biliary sludge (n=7) among the patients who achieved successful internal drainage. Median stent patency was 179 days (95% CI 104–271). Conclusion Percutaneous stent-in-stent placement with large cell-type stents is technically feasible and safe, and can be an effective technique in patients with malignant hilar biliary obstruction.

scholarly journals A novel large cell-sized stent with slim delivery for combined side-by-side and stent-in-stent placement in malignant hilar biliary obstruction

Endoscopy ◽  
2019 ◽  
Vol 52 (03) ◽  
pp. E104-E105
Author(s):  
Tadahisa Inoue ◽  
Mayu Ibusuki ◽  
Rena Kitano ◽  
Yuji Kobayashi ◽  
Kiyoaki Ito ◽  
...  
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Large Cell ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction

Su1384 A Newly Designed Large Cell Stent for Endoscopic Bilateral Stent-in-Stent Placement in Patients With Malignant Hilar Biliary Obstruction

2013 ◽  
Vol 77 (5) ◽  
pp. AB305-AB306 ◽  
Author(s):  
Kazumichi Kawakubo ◽  
Hiroshi Kawakami ◽  
Masaki Kuwatani ◽  
Shin Haba ◽  
Taiki Kudo ◽  
...  
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Large Cell ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction

Small cell- versus large cell-sized metal stent in endoscopic bilateral stent-in-stent placement for malignant hilar biliary obstruction

2015 ◽  
Vol 27 (6) ◽  
pp. 692-699 ◽  
Author(s):  
Jae Min Lee ◽  
Sang Hyub Lee ◽  
Kwang Hyun Chung ◽  
Jin Myung Park ◽  
Woo Hyun Paik ◽  
...  
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Large Cell ◽  
Small Cell ◽  
Metal Stent ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction ◽  
Cell Versus

scholarly journals Endoscopic side-by-side uncovered self-expandable metal stent placement for malignant hilar biliary obstruction

2019 ◽  
Vol 12 ◽  
pp. 263177451984634 ◽  
Author(s):  
Katsuya Kitamura ◽  
Akira Yamamiya ◽  
Yu Ishii ◽  
Yuta Mitsui ◽  
Hitoshi Yoshida
Keyword(s):  
Adverse Events ◽  
Stent Placement ◽  
Biliary Obstruction ◽  
Arterial Embolization ◽  
Metal Stents ◽  
Success Rates ◽  
Metal Stent ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction ◽  
Self Expandable Metal Stent

Aim: To investigate outcomes of endoscopic bilateral side-by-side placement across the papilla using 10-mm-diameter uncovered self-expandable metal stents for unresectable malignant hilar biliary obstruction. Methods: We retrospectively analyzed 23 patients who underwent endoscopic biliary uncovered self-expandable metal stent placement for unresectable malignant hilar biliary obstruction between January 2015 and September 2016 at our institution. We performed endoscopic side-by-side placement across the papilla using 10-mm-diameter longer-model uncovered self-expandable metal stents. Outcomes included the technical and functional success rates, recurrent biliary obstruction rate, time to recurrent biliary obstruction, reintervention rate, and incidence of adverse events other than recurrent biliary obstruction. Results: Of the 23 patients, 10 with malignant hilar biliary obstruction underwent endoscopic side-by-side uncovered self-expandable metal stent placement across the papilla (median age, 83 years; 6 men). The locations of malignant hilar biliary obstruction were Bismuth types II ( n = 3), III ( n = 3), and IV ( n = 4). The median common bile duct diameter was 8 mm. The technical and functional success rates were 100% and 80%, respectively. Seven patients (70%) developed recurrent biliary obstruction because of stent occlusions, including early hemobilia in two patients and late tumor ingrowth in five patients. The median time to recurrent biliary obstruction was 66 (95% confidence interval: 29–483) days. Six patients (60%) required reintervention, and 1 (10%) underwent transcatheter arterial embolization for right hepatic arterial pseudoaneurysm. Early adverse events other than recurrent biliary obstruction occurred in four patients and late adverse event in one patient. Conclusion: Endoscopic side-by-side placement across the papilla using 10-mm-diameter uncovered self-expandable metal stents was technically feasible for unresectable malignant hilar biliary obstruction; however, it might be better to avoid this method for patients with malignant hilar biliary obstruction because of high recurrent biliary obstruction rate and shorter time to recurrent biliary obstruction.

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