scholarly journals SpyGlass DS -Directed Radiofrequency Ablation with Double Biliary Metal Stent Placement for Managing Recurrent Obstructive Jaundice Secondary to Castleman Disease: A Case Report of a Rare Disease (with Videos)

2020 ◽  
Author(s):  
Lijia Wen ◽  
Junhong Chen ◽  
Liang Guo ◽  
Kai Liu
Keyword(s):  
Radiofrequency Ablation ◽  
Obstructive Jaundice ◽  
Abdominal Mass ◽  
Castleman Disease ◽  
Metal Stent ◽  
Stent Patency ◽  
Stent Occlusion ◽  
Upper Abdominal ◽  
Spyglass Ds ◽  
Biliary Metal Stent

Castleman disease (CD) rarely presents with obstructive jaundice, which poses a diagnostic and therapeutic challenge to the management of the disease. A 40-year-old man was referred to our hospital for emergent management of upper abdominal pain. An abdominal mass was removed, and the postoperative pathology showed retroperitoneum CD, which was subsequently managed by adjuvant therapy of combination chemotherapy and steroids. One month later, a biliary metal stent was placed due to the presentation of obstructive jaundice. After approximately 3 months, the patient experienced another episode of obstructive jaundice, and SpyGlass DS cholangioscopy (Boston Scientific, Natick, Mass, USA) was performed via the biliary track for biopsy, which pathologically showed biliary malignancies. Radiofrequency ablation was performed with a probe (EMcision, Montreal, Canada), and another uncovered metal stent was placed within the existing metal stent. No stent occlusion occurred during a 6-month follow-up period. In conclusion, CD rarely presents with obstructive jaundice, and a combination of radiofrequency ablation with metal stent implantation under cholangioscopy can prolong the stent patency time and the survival time of patients.

Mo1291 Radiofrequency Ablation for Biliary Metal Stent Occlusion: Evolution of a Novel Endoscopic Technique and Proof of Concept

2012 ◽  
Vol 75 (4) ◽  
pp. AB377-AB378 ◽  
Author(s):  
Yiannis Kallis ◽  
Natalie Phillips ◽  
Alan Steel ◽  
Robert Dickinson ◽  
Joanna Nicholls ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Endoscopic Technique ◽  
Proof Of Concept ◽  
Metal Stent ◽  
Stent Occlusion ◽  
Biliary Metal Stent

The Frequency and Management of Metal Stent Occlusion in Patients with Malignant Obstructive Jaundice

2006 ◽  
Vol 63 (5) ◽  
pp. AB305
Author(s):  
Arah Boghos ◽  
Priya Jamidar ◽  
Federico Rossi ◽  
Hashem Al-Hashem ◽  
Uzma Siddiqui ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Metal Stent ◽  
Malignant Obstructive Jaundice ◽  
Stent Occlusion

scholarly journals Safety and outcomes of endoscopic ultrasound-guided drainage for malignant biliary obstruction using cautery-enabled lumen-apposing metal stent

2020 ◽  
Vol 08 (11) ◽  
pp. E1633-E1638
Author(s):  
Jerry Yung-Lun Chin ◽  
Samir Seleq ◽  
Frank Weilert
Keyword(s):  
Clinical Success ◽  
Clinical Success Rate ◽  
Metal Stents ◽  
Metal Stent ◽  
Endoscopic Retrograde ◽  
Stent Patency ◽  
Stent Occlusion ◽  
Secondary Endpoints ◽  
Mean Time

Abstract Background and study aims There is increasing evidence to suggest that EUS-guided biliary drainage (EUS-BD) is a safe and effective treatment alternative for patients with malignant biliary obstructions (MBOs) after failed endoscopic retrograde cholangiopancreatography. Patients and methods We performed a retrospective analysis of data prospectively collected from patients with MBO who underwent choledochoduodenostomy (CDS) or gallbladder drainage (GBD) between August 2016 and June 2020 using the electrocautery-enabled lumen-apposing metal stents (ECE-LAMS). The primary endpoint was technical and clinical success. Secondary endpoints were adverse events (AEs) and reinterventions. Results A total of 60 patients were included in the study, with 56 CDS and 4 GBD. Median age was 76 years with 57 % male (34/60). The most common indication for EUS-BD was pancreatic cancer (78 %). Technical success was achieved in 100 % of cases, with a clinical success rate of 91.7 %. Mean total bilirubin pre-procedure was 202 umol/L (normal < 20 umol/L) and 63.8 umol/L post procedure (P < .001). Twenty-one patients had bilirubin recorded at 2 weeks post EUS-BD with 20 of 21 patients demonstrating > 50 % reduction in bilirubin (mean bilirubin reduction 75 %). AEs occurred in 12 of 60 patients (20 %), all of which were mild. The reintervention rate was 11.7 % (7/60). Stent occlusion occurred in 10 of 60 patients (16.7 %) with a mean time to stent occlusion of 46.2 days (3–133). Stent patency of 83.3 % was observed with a mean follow up of 7.9 months. Conclusion EUS-CDS and GBD using ECE-LAMS are effective EUS-based techniques for managing patients with MBO. AEs are usually mild and resolved by reintervention.

scholarly journals Radiotherapy Prolongs Biliary Metal Stent Patency in Malignant Pancreatobiliary Obstructions

Gut and Liver ◽  
2013 ◽  
Vol 7 (4) ◽  
pp. 480-485 ◽  
Author(s):  
Semi Park ◽  
Jeong Youp Park ◽  
Seungmin Bang ◽  
Seung Woo Park ◽  
Jae Bock Chung ◽  
...  
Keyword(s):  
Metal Stent ◽  
Stent Patency ◽  
Biliary Metal Stent

scholarly journals Aspiring to inspIRE: catheter-directed electrical therapy and biliary metal stent patency

2018 ◽  
Vol 88 (2) ◽  
pp. 388-389
Author(s):  
Meir Mizrahi ◽  
Jonah Cohen ◽  
Douglas Pleskow
Keyword(s):  
Metal Stent ◽  
Stent Patency ◽  
Electrical Therapy ◽  
Biliary Metal Stent

scholarly journals Endoscopic deployment of multiple (≥ 3) metal stents for unresectable malignant hilar biliary strictures

2019 ◽  
Vol 07 (05) ◽  
pp. E672-E677
Author(s):  
Tatsuya Koshitani ◽  
Shuji Nakagawa ◽  
Yoshitomo Konaka ◽  
Keimei Nakano ◽  
Shuichi Fuki ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Clinical Success ◽  
Guide Wire ◽  
Metal Stents ◽  
High Grade ◽  
Success Rates ◽  
Biliary Strictures ◽  
Stent Patency ◽  
Stent Occlusion

Abstract Background and study aims Endoscopic deployment of multiple (≥ 3) self-expandable metal stents (SEMS) for high-grade unresectable malignant hilar biliary strictures (UMHBS) is technically challenging. Eleven consecutive patients with high-grade UMHBS (mean age: 76 years, male/female: 5/6, Bismuth-Corlette classification IIIa/IV: 7/4) underwent endoscopic deployment of multiple SEMS using a combination of side-by-side (SBS) and stent-in-stent (SIS) methods. Technical and clinical success rates were 11/11. More than three SEMS were successfully deployed, and obstructive jaundice was fully improved in all cases. Stent occlusion was recognized in four of 11 patients (mean: 134 days, range: 28 – 232). Reinterventions for both liver lobes were feasible by passing the guide wire inside the previously placed stents in three of four patients. Median stent patency was 150 days during a mean follow-up period of 184 days (range: 37 – 558). Three patients developed self-limiting cholangitis without definite stent occlusion as late (> 30 days) adverse events. Employing the combination of SBS and SIS methods may facilitate endoscopic deployment of multiple SEMS to treat high-grade UMHBS.

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