Multi‐center study of endoscopic revision after side‐by‐side metal stent placement for malignant hilar biliary obstruction

2020 ◽  
Author(s):  
Tadahisa Inoue ◽  
Itaru Naitoh ◽  
Yuta Suzuki ◽  
Fumihiro Okumura ◽  
Kenichi Haneda ◽  
...  
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Metal Stent ◽  
Endoscopic Revision ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction ◽  
Multi Center Study ◽  
Center Study

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.

T1527: Y-Shaped Endoscopic Bilateral Metal Stent Placement for Malignant Hilar Biliary Obstruction: Efficacy of a Biliary Y-Stent

2010 ◽  
Vol 71 (5) ◽  
pp. AB300-AB301
Author(s):  
Jin Hong Kim ◽  
Jae Chul Hwang ◽  
Yoonchul Lee ◽  
Sun Gyo Lim ◽  
Byung Moo Yoo
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Metal Stent ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction

scholarly journals Side-by-side partially covered self-expandable metal stent placement for malignant hilar biliary obstruction

2017 ◽  
Vol 05 (12) ◽  
pp. E1211-E1217 ◽  
Author(s):  
Katsuya Kitamura ◽  
Akira Yamamiya ◽  
Yu Ishii ◽  
Yuta Mitsui ◽  
Tomohiro Nomoto ◽  
...  
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Success Rates ◽  
Metal Stent ◽  
Stent Removal ◽  
Tumor Ingrowth ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction ◽  
Self Expandable Metal Stent

Abstract Background and study aims This study investigated the feasibility of side-by-side (SBS) partially covered self-expandable metal stent (PCSEMS) placement for unresectable malignant hilar biliary obstruction (MHBO). Patients and methods We retrospectively analyzed 33 patients from a single center who underwent endoscopic biliary drainage for unresectable MHBO from July 2013 to June 2015. In all patients with bilateral obstruction during complete bilateral intrahepatic cholangiograms, we performed endoscopic SBS placement of a 6-mm diameter PCSEMS using an 8-French delivery system. All patients underwent endoscopic sphincterotomy. Generally, patients with recurrent biliary obstruction (RBO) after stent placement underwent endoscopic reintervention. Our study outcomes included the technical and functional success rates, RBO rate, time to RBO (TRBO), reintervention rate, and incidence of adverse events. Results Seventeen patients with unresectable MHBO during complete bilateral intrahepatic cholangiograms underwent endoscopic SBS PCSEMS placement (median age, 78 years; men, 9). Lesions were Bismuth types II (n = 10), III (n = 1), and IV (n = 6), including 10 cholangiocarcinomas, 3 gallbladder cancers, and 4 metastatic cancers. In all patients, the PCSEMS was placed across the duodenal papilla. The technical and functional success rates were 100 % and 82 %, respectively. The median procedure time was 43 minutes (interquartile range [IQR]: 36 – 52 minutes). Twelve patients had RBO (71 %), including 9 stent occlusions due to sludge and 3 stent migrations. The median TRBO was 79 days (IQR: 58 – 156 days) during the follow-up period (median 192 days [IQR: 88 – 551 days]). The median TRBO of patients with Bismuth type II lesions was significantly longer than that of patients with Bismuth types III and IV lesions (87 days [IQR: 70 – 244 days] vs. 54 days [IQR: 35 – 100 days]; P  = 0.030). Thirteen patients (76 %) required endoscopic reintervention. Endoscopic stent removal was possible in 6 patients without tumor ingrowth into the uncovered distal part of the stent. One late adverse event (≥ 31 days) occurred (cholangitis). Conclusions Endoscopic SBS placement of a PCSEMS was feasible in patients with unresectable MHBO. Additionally, reinterventional stent removal was possible in the absence of tumor ingrowth.

scholarly journals Novel 7-mm-diameter double bare metal stent for endoscopic side-by-side stent placement in malignant hilar biliary obstruction

VideoGIE ◽  
2020 ◽  
Vol 5 (5) ◽  
pp. 201-202
Author(s):  
Satoshi Asai ◽  
Kotaro Takeshita ◽  
Takumi Ichinona ◽  
Eisuke Akamine ◽  
Naoki Fujimoto
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Bare Metal Stent ◽  
Bare Metal ◽  
Metal Stent ◽  
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 S1056 Stent-in-Stent vs Side-by-Side Metal Stent Placement for Malignant Hilar Biliary Obstruction; A Meta-Analysis of Comparative Evidence

2021 ◽  
Vol 116 (1) ◽  
pp. S500-S500
Author(s):  
Faisal Ali ◽  
Humaed Mohammed Abdul ◽  
Mohammed Gandam ◽  
Zain I. Siddiqui ◽  
Noor Mualla ◽  
...  
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Meta Analysis ◽  
Metal Stent ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction

scholarly journals Endoscopic ultrasound-guided antegrade metal stent placement using the stent-in-stent technique in a patient with malignant hilar biliary obstruction

2018 ◽  
Vol 7 (3) ◽  
pp. 204 ◽  
Author(s):  
Hiroshi Yamauchi ◽  
Mitsuhiro Kida ◽  
Shiro Miyazawa ◽  
Kosuke Okuwaki ◽  
Tomohisa Iwai ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Stent Placement ◽  
Biliary Obstruction ◽  
Metal Stent ◽  
Ultrasound Guided ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction
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