Serious Complications after Self-expandable Metallic Stent Insertion in a Patient with Malignant Lymphoma

Abstract Background and aim To assess the rate of adverse events and the technical success rate of biliary stenting with or without EBS. Methods A literature search up to February 2017 was performed. Studies assessing adverse events (AEs) and technical success rates of stenting with or without EBS were considered. Results Seven studies (870 patients; 12 treatment arms) were included. Early AEs, i. e. those occurring within 30 days, were significantly lower in no-EBS vs. EBS-group (11 % vs. 20.1 %; OR: 0.36, 95 %CI: 0.13 – 1.00). Rates of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis were not significantly different in the two groups (no-EBS vs. EBS: 6.1 % vs 5 %; OR: 1.33, 95 %CI: 0.68 – 2.59). The rate of bleeding was significantly lower in patients without EBS (no-EBS vs EBS: 0 % vs 5 %; OR: 0.12, 95 % CI: 0.03 – 0.45). Rates of cholangitis were significantly lower in patients without EBS (no-EBS vs. EBS: 3.3 % vs. 7.4 %; OR: 0.38, 95 %CI: 0.17 – 0.83). Both late AEs and mortality rates did not significantly differ between no-EBS and EBS patients (19.9 % vs. 18.9 %; OR: 0.93, 95 %CI: 0.56 – 1.53, and 2.5 % vs. 2.9 %; OR: 1.18, 95 %CI: 0.22 – 6.29, respectively). The technical success rate for stent insertion also did not differ (98 % vs. 97.6 %; OR: 1.05, 95 %CI: 0.42 – 2.63). Conclusion EBS seems to be associated, in the first 30 days after the procedure, with an increased risk of cholangitis and bleeding. No difference was observed in the rate of post-ERCP pancreatitis.

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Successful Stent-in-stent Insertion of an Expandable Metallic Stent Covered with Polyuretane Placed to Obliterate a Large Bronchial Fistula after Chemoradiotherapy for Inoperable Lung Cancer.

Haigan ◽

10.2482/haigan.39.877 ◽

1999 ◽

Vol 39 (6) ◽

pp. 877-880

Author(s):

Hiroya Minami ◽

Noriaki Tsubota ◽

Yoshifumi Miyamoto ◽

Masahiro Yoshimura ◽

Kayoko Obayashi ◽

...

Keyword(s):

Lung Cancer ◽

Stent Insertion ◽

Metallic Stent ◽

Bronchial Fistula ◽

Expandable Metallic Stent

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Outcomes of second self-expandable metallic stent insertion for malignant gastric outlet obstruction

Surgical Endoscopy ◽

10.1007/s00464-013-3185-z ◽

2013 ◽

Vol 28 (1) ◽

pp. 281-288 ◽

Cited By ~ 14

Author(s):

Chan Gyoo Kim ◽

Il Ju Choi ◽

Jong Yeul Lee ◽

Soo-Jeong Cho ◽

Soo Jin Kim ◽

...

Keyword(s):

Gastric Outlet Obstruction ◽

Outlet Obstruction ◽

Stent Insertion ◽

Metallic Stent ◽

Malignant Gastric Outlet Obstruction ◽

Expandable Metallic Stent

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The Effectiveness of Self-Expandable Metallic Stent Insertion in Treating Right-Sided Colonic Obstruction: A Comparison between SEMS and Decompression Tube Placement and an Investigation of the Safety and Difficulties of SEMS Insertion in Right Colons

Gastroenterology Research and Practice ◽

10.1155/2014/372918 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 14

Author(s):

Rintaro Moroi ◽

Katsuya Endo ◽

Ryo Ichikawa ◽

Hiroshi Nagai ◽

Hirohiko Shinkai ◽

...

Keyword(s):

Clinical Success ◽

Colonic Obstruction ◽

Clinical Success Rate ◽

Technical Difficulty ◽

Tube Placement ◽

Stent Insertion ◽

Metallic Stent ◽

Expandable Metallic Stent ◽

Malignant Colonic Obstruction ◽

Decompression Tube

Objectives.Self-expandable metallic stent (SEMS) is widely used to treat malignant colonic obstruction. However, most reports about SEMS insertion have concentrated on the left colon. This study aimed to (1) investigate the effectiveness of SEMS insertion compared with conventional decompression tube for right-sided colonic obstruction and (2) compare the safety and technical success of SEMS insertion between left- and right-sided colonic obstructions.Methods.The data from thirty-seven patients who underwent SEMS or conventional decompression tube placement for malignant colonic obstruction in our hospital were analyzed retrospectively. Technical and clinical success, complications, and technical difficulties were analyzed. We compared the results between SEMS insertion and decompression tube placement in right colons and the outcomes of SEMS insertion between right- and left-sided colonic obstructions.Results.For right colons, the clinical success rate of SEMS insertion (100%) was significantly higher than that of decompression tube placement (55.9%). Concerning SEMS insertion, the technical difficulty and safety of SEMS insertion were similar between right- and left-sided colonic obstructions.Conclusion.SEMS insertion for right-sided colon is significantly more effective than conventional decompression tube placement, and this procedure was safer and less technically challenging than expected. SEMS insertion should be considered for treating right-sided malignant colonic obstruction.

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Clinical Impact of Prophylactic Antibiotic Treatment for Self-Expandable Metallic Stent Insertion in Patients with Malignant Colorectal Obstruction

Gastroenterology Research and Practice ◽

10.1155/2015/416142 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7

Author(s):

Jong-Sun Kim ◽

Wan-Sik Lee ◽

Cho-Yun Chung ◽

Hyung-Chul Park ◽

Dae-Seong Myung ◽

...

Keyword(s):

Risk Factor ◽

Prophylactic Antibiotic ◽

Infectious Complications ◽

Stent Insertion ◽

Metallic Stent ◽

Colorectal Obstruction ◽

Propensity Score Matching Analysis ◽

Expandable Metallic Stent ◽

Potential Risk Factors ◽

Prophylactic Antibiotic Treatment

Purpose. The aim of this study was to determine the efficacy of prophylactic antibiotics (PA) for reducing the infectious complications and the potential risk factors responsible for the infectious complications after stent insertion for malignant colorectal obstruction.Methods. We performed a retrospective review of 224 patients who underwent self-expandable metallic stent (SEMS) insertion for malignant colorectal obstruction from May 2004 to December 2012.Results. There were 145 patients in the PA group and 79 in non-PA group. The CRP level in PA group was significantly higher than that in non-PA. Abdominal tenderness and mechanical ileus were significantly more frequent in PA group than those in non-PA. The frequency of post-SEMS insertion fever, systemic inflammatory response syndrome (SIRS), and bacteremia was not significantly different between PA and non-PA groups. In multivariate analysis, the CRP level was risk factor related to post-SEMS insertion SIRS. However, in propensity score matching analysis, there was no independent risk factor related to post-SEMS insertion fever, SIRS, and bacteremia.Conclusion. The use of PA in patients with malignant colorectal obstruction may be not effective to prevent the development of infectious complications after SEMS insertion.

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Safety and Feasibility of Self-Expandable Metallic Stent Insertion for the Right-Side Colonic Malignant Obstruction and Its Clinical Benefits

Journal of Minimally Invasive Surgery ◽

10.7602/jmis.2015.18.1.19 ◽

2015 ◽

Vol 18 (1) ◽

pp. 19-23

Author(s):

Seok Hwan Choi ◽

Jung Myun Kwak ◽

Dong Woo Kang ◽

Han Deok Kwak ◽

Nak Song Sung ◽

...

Keyword(s):

Stent Insertion ◽

Metallic Stent ◽

Malignant Obstruction ◽

Expandable Metallic Stent ◽

Clinical Benefits ◽

The Right

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Comparison of an Inside Stent and a Fully Covered Self-Expandable Metallic Stent as Preoperative Biliary Drainage for Patients with Resectable Perihilar Cholangiocarcinoma Retrospectively.

10.21203/rs.3.rs-1117178/v1 ◽

2021 ◽

Author(s):

Hiroshi Mori ◽

Hiroki Kawashima ◽

Eizaburo Ohno ◽

Takuya Ishikawa ◽

Yasuyuki Mizutani ◽

...

Keyword(s):

Postoperative Complications ◽

Adverse Events ◽

Pancreatic Fistula ◽

Biliary Drainage ◽

Preoperative Biliary Drainage ◽

Perihilar Cholangiocarcinoma ◽

Stent Insertion ◽

Metallic Stent ◽

Expandable Metallic Stent ◽

Significant Difference

Abstract BackgroundThere is a need for a more tolerable preoperative biliary drainage (PBD) method for perihilar cholangiocarcinoma (PHCC). In recent years, inside stents (ISs) have attracted attention as a less suffering PBD method. Few studies have compared IS with a fully covered self-expandable metallic stent (FCSEMS) as PBD for resectable PHCC. The aim of this study is to compare them.MethodsThis study involved 87 consecutive patients (IS: 51, FCSEMS: 36). The recurrent biliary obstruction (RBO) rate until undergoing surgery or being diagnosed as unresectable, time to RBO, factors related to RBO, incidence of adverse events related to endoscopic retrograde cholangiography and postoperative complications associated with each stent were evaluated retrospectively.ResultsThere was no significant difference between the two groups in the incidence of adverse events after stent insertion. The mean (s.d.) time to RBO was 40.0 (28.1) days in the IS group and 52.0 (45.5) days in the FCSEMS group, with no significant difference (P=0.384). A total of 7/51 patients in the IS group and 3/36 patients in the FCSEMS group developed RBO. The only risk factor for RBO was bile duct obstruction of the future excisional liver lobe(s) due to stenting (HR 0.033, P=0.006) in the FCSEMS group, but risk factors could not be indicated in the IS group. Regarding postoperative complications, there was no significant difference in the incidence of bile leakage or liver failure. In contrast, pancreatic fistula was significantly more common in the FCSEMS group (13/24 patients) than in the IS group (3/28 patients) (P=0.001), especially in patients who did not undergo pancreatectomy (P=0.001).ConclusionsAs PBD for PHCC, both IS and FCSEMS achieved low RBO rates. In contrast, the incidence of postoperative pancreatic fistula was higher with FCSEMS. Thus, IS, which can be inserted easily, is considered an optimal approach as PBD for resectable PHCC.clinical trial registration number: UMIN000025631

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