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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...

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Autores principales: Yue, Qing, Han, Wei, Liu, Zi-ling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
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.
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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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