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Endoscopic reintervention after unilateral metal stent deployment for MHBO using SIS method
Endoscopic biliary drainage is the main treatment for unresectable malignant hilar biliary obstruction (MHBO). Recurrent biliary obstruction (RBO) often occurs after unilateral metal stent deployment. Endoscopic reintervention can be complex for this problem, especially for drainage of the contralat...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10378984/ https://www.ncbi.nlm.nih.gov/pubmed/37505126 http://dx.doi.org/10.1097/MD.0000000000034467 |
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author | Yue, Qing Han, Wei Liu, Zi-ling |
author_facet | Yue, Qing Han, Wei Liu, Zi-ling |
author_sort | Yue, Qing |
collection | PubMed |
description | Endoscopic biliary drainage is the main treatment for unresectable malignant hilar biliary obstruction (MHBO). Recurrent biliary obstruction (RBO) often occurs after unilateral metal stent deployment. Endoscopic reintervention can be complex for this problem, especially for drainage of the contralateral bile duct. The stent-in-stent (SIS) method is a possible solution to this problem. Our objective was to evaluate the safety and feasibility of the SIS method for endoscopic reintervention in patients with RBO due to MHBO after unilateral metal stent deployment. Eleven patients with MHBO received endoscopic reintervention using the SIS method to manage RBO after unilateral metal stent deployment. Clinical data, including technical and clinical success, procedure time, adverse events and complications, stent patency, RBO of the revisionary stent, and survival time were recorded. Nine patients (82%) achieved technical success, and all 9 of them also achieved clinical success. The 2 unsuccessful cases received percutaneous transhepatic cholangial drainage. The median procedure time was 73 minutes. The 3 adverse events were post-endoscopic retrograde cholangiopancreatography pancreatitis, cholangitis, and liver abscess. 6 patients (67%) experienced RBO of the revisionary stent, the median time to RBO of the revisionary stent was 95.5 days, the median survival time after reintervention was 111 days, and the median overall survival time was 305.5 days. Endoscopic reintervention after previous unilateral metal stent deployment using the SIS method appears to be safe and technically feasible for MHBO patients who experience RBO. |
format | Online Article Text |
id | pubmed-10378984 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-103789842023-07-29 Endoscopic reintervention after unilateral metal stent deployment for MHBO using SIS method Yue, Qing Han, Wei Liu, Zi-ling Medicine (Baltimore) Research Article: Observational Study Endoscopic biliary drainage is the main treatment for unresectable malignant hilar biliary obstruction (MHBO). Recurrent biliary obstruction (RBO) often occurs after unilateral metal stent deployment. Endoscopic reintervention can be complex for this problem, especially for drainage of the contralateral bile duct. The stent-in-stent (SIS) method is a possible solution to this problem. Our objective was to evaluate the safety and feasibility of the SIS method for endoscopic reintervention in patients with RBO due to MHBO after unilateral metal stent deployment. Eleven patients with MHBO received endoscopic reintervention using the SIS method to manage RBO after unilateral metal stent deployment. Clinical data, including technical and clinical success, procedure time, adverse events and complications, stent patency, RBO of the revisionary stent, and survival time were recorded. Nine patients (82%) achieved technical success, and all 9 of them also achieved clinical success. The 2 unsuccessful cases received percutaneous transhepatic cholangial drainage. The median procedure time was 73 minutes. The 3 adverse events were post-endoscopic retrograde cholangiopancreatography pancreatitis, cholangitis, and liver abscess. 6 patients (67%) experienced RBO of the revisionary stent, the median time to RBO of the revisionary stent was 95.5 days, the median survival time after reintervention was 111 days, and the median overall survival time was 305.5 days. Endoscopic reintervention after previous unilateral metal stent deployment using the SIS method appears to be safe and technically feasible for MHBO patients who experience RBO. Lippincott Williams & Wilkins 2023-07-28 /pmc/articles/PMC10378984/ /pubmed/37505126 http://dx.doi.org/10.1097/MD.0000000000034467 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. |
spellingShingle | Research Article: Observational Study Yue, Qing Han, Wei Liu, Zi-ling Endoscopic reintervention after unilateral metal stent deployment for MHBO using SIS method |
title | Endoscopic reintervention after unilateral metal stent deployment for MHBO using SIS method |
title_full | Endoscopic reintervention after unilateral metal stent deployment for MHBO using SIS method |
title_fullStr | Endoscopic reintervention after unilateral metal stent deployment for MHBO using SIS method |
title_full_unstemmed | Endoscopic reintervention after unilateral metal stent deployment for MHBO using SIS method |
title_short | Endoscopic reintervention after unilateral metal stent deployment for MHBO using SIS method |
title_sort | endoscopic reintervention after unilateral metal stent deployment for mhbo using sis method |
topic | Research Article: Observational Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10378984/ https://www.ncbi.nlm.nih.gov/pubmed/37505126 http://dx.doi.org/10.1097/MD.0000000000034467 |
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