Combined percutaneous–endoscopic stenting of malignant biliary obstruction: results from 106 consecutive procedures and identification of factors associated with adverse outcome

Most patients with malignant obstructive jaundice present at a stage when they are beyond the scope of curative surgery. Endoscopic stenting is the approach of choice worldwide to improve quality of life and survival of such patients. The aim of this study was to find out overall clinical outcome of endoscopic intervention in malignant obstructive jaundice. This prospective study done in two tertiary gastroenterology centers in Dhaka included consecutively admitted 79 adult patients with malignant biliary obstruction for endoscopic stenting, followed by a follow-up period of six months. Outcome evaluation included success rate of stenting and drainage, complications, and mortality rate at one-month, and survival up to six-months. ERCP revealed carcinoma of pancreas, periampullary carcinoma, cholangiocarcinoma, carcinoma of gallbladder, and metastasis in the biliary trees in 22 (27.8%), 22 (27.8%), 20 (25.3%), 11 (13.9%), and 04 (5.1%) cases respectively. Successful stenting and drainage could be achieved in 62 (78.5%) and 58 (73.4%) cases. Stent blockage (23.9%) and cholangitis (19.4%) were the main complications. Total death at one-month was nine of 55 (16.4%), and 21 (38.2%) patients survived up to six-months, with no difference in one-month mortality rate among the malignancies (P>0.05). Stenting prolonged six-month (88.2%) and mean survival (121.2±67.7 days) only in patients with periampullary carcinoma (P<0.001). Endoscopic stenting can safely be done in malignant biliary obstruction to offer palliation with an outcome, which is not unsatisfactory. (J Bangladesh Coll Phys Surg 2006; 24: 61-68)

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Lumen-apposing metal stent for treatment of malignant biliary obstruction, placed through an uncovered duodenal self-expanding metal stent

BMJ Case Reports ◽

10.1136/bcr-2020-238599 ◽

2021 ◽

Vol 14 (4) ◽

pp. e238599

Author(s):

Rasmus Due-Petersson ◽

Lasse Bremholm Hansen

Keyword(s):

Pancreatic Cancer ◽

Biliary Obstruction ◽

Malignant Disease ◽

Oral Intake ◽

Malignant Biliary Obstruction ◽

Metal Stents ◽

Endoscopic Stenting ◽

Duodenal Stenosis ◽

Metal Stent ◽

Duodenal Stent

The development and refinement of endoscopic stenting techniques in recent years have made endoscopic treatment an important part of palliative care for irresectable malignant disease in the gastrointestinal tract. We present the case of a 82-year-old man with biliary obstruction and duodenal stenosis on the basis of disseminated pancreatic cancer. He was bothered by jaundice and reduced oral intake. This is typically alleviated using stents; however, the placement of a duodenal stent can limit the possibility of subsequent placement of a biliary stent. This therapeutic challenge was solved using a combination of lumen-apposing metal stents (LAMS) and self-expanding uncovered metal stents (SEMS). LAMS is a relatively novel type of stent intended for endoscopic ultrasonography-guided placement. First, we placed a SEMS in the duodenum, a LAMS was subsequently placed through the mesh of the duodenal SEMS, alleviating the biliary system. The patient was able to resume oral intake and his jaundice subsided.

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PWE-142 Endoscopic stenting for malignant biliary obstruction: a 3-year review

Gut ◽

10.1136/gutjnl-2012-302514d.142 ◽

2012 ◽

Vol 61 (Suppl 2) ◽

pp. A354.1-A354

Author(s):

R Mahmood ◽

N C Fisher

Keyword(s):

Biliary Obstruction ◽

Malignant Biliary Obstruction ◽

Endoscopic Stenting

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ENDOSCOPIC BILIARY DRAINAGE AS PALLIATIVE TREATMENT FOR MALIGNANT BILIARY OBSTRUCTION: FINDINGS AND FACTORS ASSOCIATED WITH THE SUCCESSOR FAILURE

International Journal of Advanced Research ◽

10.21474/ijar01/13481 ◽

2021 ◽

Vol 9 (09) ◽

pp. 787-792

Author(s):

Addajou Tarik ◽

◽

Rokhsi Soukaina ◽

Mrabti Samir ◽

Benhamdane Ahlame ◽

...

Keyword(s):

Biliary Obstruction ◽

Malignant Biliary Obstruction ◽

Endoscopic Biliary Drainage ◽

Cancer Du Pancréas ◽

Voies Biliaires ◽

Factors Associated ◽

Dilatation Endoscopique ◽

Drainage Endoscopique ◽

Analyse Multivariée ◽

Étude Rétrospective

Introduction: Le drainage biliaire endoscopique connait des progres incessants et prend une large place dans le traitement palliatif des stenoses malignes des voies biliaires. Notre objectif est dexposer les resultats de cette technique dans notre formation, ainsi que les differents facteurs associes a son echec ou son succes. Methodes:Il sagit dune etude retrospective entre Janvier 2008 et novembre 2020, a propos de 204 patientsayant beneficie dun drainage endoscopique pour stenose biliaire dorigine neoplasique, et qui sont repartis en 3 groupes: les patients atteints dun cholongiocarcinome dans le groupe A , dun cancer du pancreas dans groupe B , et dun calculocancer dans le groupe C . Lanalyse statistique a ete realisee par le logiciel SPSS20.0. Resultats:Lage moyen etait de 63,5Â±11,4 ans avec un sex ratio a 1,4. Le succes global etait de 82,4% et letude comparative des resultats dans les 3 groupes a montre un taux de succes a 86,6% du groupe B, suivi du groupe C a 80,8% et du groupe A a 76,4%. En analyse multivariee et en ajustant les parametres etudies, a savoir le sexe, lage, limagerie, la presence de metastases et la dilatation endoscopique de la stenose, seule la presence de metastases et la dilatation endoscopique de la stenose modifient le taux de succes. La dilatation endoscopique de la stenose avant la mise en place de prothese multiplie par 8 le taux de succes [OR=9,177p<0,001], alors que la presence de metastases diminue ce taux de 88% et augmente le risque dechec [OR=0,117 p<0,001]. Conclusion:Notre etude a demontre que la presence de metastases semble etre significativement associee a lechec du drainage biliaire endoscopique et la dilatation endoscopique avant la mise en place de la prothese semble etre associee a son succes.

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