Early Infectious Complications of Percutaneous Metallic Stent Insertion for Malignant Biliary Obstruction

2010 ◽  
Vol 194 (1) ◽  
pp. 261-265 ◽  
Author(s):  
Yu Li Sol ◽  
Chang Won Kim ◽  
Ung Bae Jeon ◽  
Nam Kyung Lee ◽  
Suk Kim ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Infectious Complications ◽  
Malignant Biliary Obstruction ◽  
Stent Insertion ◽  
Metallic Stent

Fractures of self-expanding metallic stents in periampullary malignant biliary obstruction

2009 ◽  
Vol 50 (7) ◽  
pp. 730-737 ◽  
Author(s):  
I. C. Rasmussen ◽  
U. Dahlstrand ◽  
G. Sandblom ◽  
L. G. Eriksson ◽  
R. Nyman
Keyword(s):  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Metallic Stents ◽  
Biliary Duct ◽  
Stent Insertion ◽  
Stent Fracture ◽  
Metallic Stent ◽  
Stent Patency ◽  
Life Threatening ◽  
The Mean

Background: Self-expanding metallic stents are widely used for relieving biliary duct obstruction in patients with unresectable periampullary malignancies. However, only a few studies have assessed the occurrence of fractures in these stents. Purpose: To determine the prevalence and significance of stent fracture after placement of self-expanding metallic stents for periampullary malignant biliary obstruction. Material and Methods: Over a 5-year period, 48 patients underwent placement of self-expanding metallic stents for periampullary malignant biliary obstructions. Stents were introduced 2–6 weeks after a percutaneous transhepatic biliary decompression. The medical records and relevant images were reviewed for stent patency, stent fracture, type of stent, and stent-related complications. Results: Stent fracture was detected in four of the 48 patients (8%): in one patient at 1 month and in three patients between 10 and 21 months after stenting. All four fractures involved one type of nitinol stent used in 38 patients. In one of the patients, fracture was complicated by life-threatening gastrointestinal bleeding. The mean survival time for all patients was 251 days (standard deviation [SD]±275 days) and the mean overall patency time for all stents was 187 days (SD±205 days). Conclusion: Stent fracture occurs after placement of self-expanding nitinol stents for periampullary malignant biliary obstruction. The low reported incidence of this complication may be due to a lack of awareness of and difficulty in detecting stent fracture. Fracture should be considered as a possible contributing factor in recurrent biliary obstruction after self-expanding metallic stent insertion.

The use of self expandable metallic stent in the management of malignant biliary obstruction

1993 ◽  
Vol 29 (3) ◽  
pp. 457
Author(s):  
Joon Koo Han ◽  
Byung Ihn Choi ◽  
Jin Wook Chung ◽  
Jae Hyung Park ◽  
Gi Seok Han ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Metallic Stent ◽  
Use Of Self ◽  
Expandable Metallic Stent

Percutaneous use of ePTFE/FEP-covered metallic stent for palliation of malignant biliary obstruction

2014 ◽  
Vol 23 (6) ◽  
pp. 366-373
Author(s):  
Charles Edouard Zurstrassen ◽  
Aline Cristine Barbosa Santos ◽  
Chiang Jeng Tyng ◽  
João Paulo Matushita ◽  
Felipe Jose Coimbra ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Metallic Stent ◽  
Covered Metallic Stent

scholarly journals Novel metallic stent designed for endoscopic bilateral stent-in-stent placement in patients with hilar malignant biliary obstruction

Endoscopy ◽  
2018 ◽  
Vol 51 (02) ◽  
pp. E30-E31 ◽  
Author(s):  
Mamoru Takenaka ◽  
Kentaro Yamao ◽  
Kosuke Minaga ◽  
Atsushi Nakai ◽  
Shunsuke Omoto ◽  
...  
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Metallic Stent

scholarly journals Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Chuanguo Zhou ◽  
Baojie Wei ◽  
Jianfeng Wang ◽  
Qiang Huang ◽  
Hui Li ◽  
...  
Keyword(s):  
Clinical Features ◽  
Biliary Obstruction ◽  
Balloon Dilation ◽  
Malignant Biliary Obstruction ◽  
Stent Fracture ◽  
Metallic Stent ◽  
Survival Times ◽  
Stent Deployment ◽  
Stent Patency ◽  
Stent Occlusion

Background. Palliative therapies for malignant biliary obstruction (MBO) include choledochojejunostomy and self-expanding metallic stent (SEMS) insertion. Fractures following SEMS insertion in MBO treatment are scarce. Objective. To assess the clinical features of biliary stent fractures and evaluate associated factors. Methods. One hundred fifty-six consecutive patients who underwent biliary SEMS placement for MBO treatment at Beijing Chaoyang Hospital affiliated to Capital Medical University, in 2010–2015, were evaluated retrospectively. Demographics, clinical features, stent parameters and patency times, and survival times were collected. Across the ampulla of Vater, balloon dilatation, number of stents, stent patency time, and survival time were compared between the stent and nonstent fracture groups. Results. There were 168 biliary metallic stents inserted in 156 patients, including 144 and 12 patients with one and 2-3 stents, respectively. Pre- and/or postballoon dilation was performed in 107 patients. Stents across and above the duodenal papilla were used in 105 and 51 patients, respectively. Six cases (3.8%) with stent occlusion had stent fractures. Single- and multiple-stent fracture rates were 4/144 (2.8%) and 2/12 (16.7%), respectively. Fracture times after stent deployment were 126.8 ± 79.0 (median, 115.5) days. Stent patency times in the stent and nonstent fracture groups were 151.8 ± 67.8 (median, 160.5) days and 159.3 ± 73.6 (median, 165.5) days, respectively. Overall survival times in the stent and nonstent fracture groups were 399.7 ± 147.6 (median, 364.0) days and 283.7 ± 126.1 (median, 289.0) days, respectively. Conclusion. Stent fractures following MBO treatment constitute a relatively rare long-term complication. Though there were no factors found to be significantly associated with SEMSs fracture, a trend could be observed towards more fractures in multistent, transpapillary, and balloon dilation groups.

scholarly journals Self-Expanding Metallic Stents in Malignant Biliary Obstruction-Patency and Clinical Efficacy: A Prospective Study from North India Tertiary Center

2019 ◽  
Vol 10 (01) ◽  
pp. 033-038
Author(s):  
Ankit Gupta ◽  
Gaurav Kumar Gupta ◽  
Atul Gawande ◽  
Manoj Kumar ◽  
Vijyant Tak ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Biliary Obstruction ◽  
Biliary Stricture ◽  
Clinical Success ◽  
Malignant Biliary Obstruction ◽  
Metallic Stent ◽  
Technical Success ◽  
Sems Placement ◽  
Tertiary Center ◽  
Hilar Biliary Stricture

ABSTRACT Background and Aims: Endoscopic insertion of self-expandable metallic stent (SEMS) is now accepted as first line modality of treatment for palliation in unresectable extra-hepatic biliary obstructive jaundice. This study was done to assess the clinical efficacy and duration of patency of endoscopically inserted metallic stent in un-resectable malignant biliary obstruction. Materials and Methods: Between 2015 to 2017, 101 patients who underwent ERCP and SEMS placement for palliation of malignant biliary obstruction were included prospectively. Main outcome measures were technical success, clinical success, mean duration of SEMS patency, clinical efficacy, rate of biliary re-intervention and survival of patients. Results: Overall technical success and clinical success was achieved in 93% and 82.2% respectively. Mean duration of SEMS patency was 109 days. Analysis in subgroup of patients classified according to site of obstruction (Hilar -68, Distal CBD-33) showed that median duration of stent patency was significantly better in distal biliary stricture (135 days vs 95 days), whereas re-intervention rates were higher in higher biliary stricture than distal stricture (41% Vs 6%). Seven patients with hilar biliary stricture suffered post-SEMS insertion cholangitis. Conclusion: SEMS placement is feasible palliative method for un-resectable malignant biliary obstruction with acceptable technical and clinical success. The duration of SEMS patency and clinical efficacy is significantly better in distal biliary stricture whereas re-intervention rate is higher in hilar biliary stricture.

scholarly journals Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051988784
Author(s):  
Chuanguo Zhou ◽  
Hui Li ◽  
Qiang Huang ◽  
Jianfeng Wang ◽  
Kun Gao
Keyword(s):  
Overall Survival ◽  
Biliary Obstruction ◽  
Median Overall Survival ◽  
Malignant Biliary Obstruction ◽  
Group Differences ◽  
Complication Rates ◽  
Metallic Stent ◽  
Stent Patency ◽  
Expandable Metallic Stent ◽  
Iodine 125

Objective To assess the safety and effectiveness of a self-expandable metallic stent (SEMS) combined with Iodine-125 seeds strand to treat hilar malignant biliary obstruction (MBO). Methods This retrospective study included patients who had received SEMS with 125I seeds strand (seeds group) or SEMS alone (controls) to treat hilar MBO. Demographic, biochemical, stent patency, overall survival and complications data were extracted and analysed. Results A total of 76 patients were included (seeds group, n = 40; controls, n = 36), with a total of 608 seeds deployed in the seeds group (mean, 15.2 ± 4.1 [range, 8–25] seeds per patient). Statistically significant between-group differences were shown in median stent patency time (seeds group, 387.0 ± 27.9 days [95% confidence interval {CI} 332.4, 441.6] versus controls, 121.0 ± 9.1 days [95% CI 103.2, 138.8]) and in median overall survival (seeds group, 177.0 ± 17.9 days [95% CI 141.8, 212.2] versus controls, 123.0 ± 20.4 [95% CI 83.0, 163.0]). There were no statistically significant between-group differences in complication rates. Conclusion SEMS combined with 125I seeds strand is safe, feasible, and tolerable in treating patients with hilar MBO, and may be effective in prolonging stent patency time and overall survival.

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