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

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-C...

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Autores principales: Koshitani, Tatsuya, Nakagawa, Shuji, Konaka, Yoshitomo, Nakano, Keimei, Fuki, Shuichi, Itoh, Yoshito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2019
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499609/
https://www.ncbi.nlm.nih.gov/pubmed/31061879
http://dx.doi.org/10.1055/a-0849-9334
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author Koshitani, Tatsuya
Nakagawa, Shuji
Konaka, Yoshitomo
Nakano, Keimei
Fuki, Shuichi
Itoh, Yoshito
author_facet Koshitani, Tatsuya
Nakagawa, Shuji
Konaka, Yoshitomo
Nakano, Keimei
Fuki, Shuichi
Itoh, Yoshito
author_sort Koshitani, Tatsuya
collection PubMed
description 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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spelling pubmed-64996092019-05-06 Endoscopic deployment of multiple (≥ 3) metal stents for unresectable malignant hilar biliary strictures Koshitani, Tatsuya Nakagawa, Shuji Konaka, Yoshitomo Nakano, Keimei Fuki, Shuichi Itoh, Yoshito Endosc Int Open 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. © Georg Thieme Verlag KG 2019-05 2019-05-03 /pmc/articles/PMC6499609/ /pubmed/31061879 http://dx.doi.org/10.1055/a-0849-9334 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Koshitani, Tatsuya
Nakagawa, Shuji
Konaka, Yoshitomo
Nakano, Keimei
Fuki, Shuichi
Itoh, Yoshito
Endoscopic deployment of multiple (≥ 3) metal stents for unresectable malignant hilar biliary strictures
title Endoscopic deployment of multiple (≥ 3) metal stents for unresectable malignant hilar biliary strictures
title_full Endoscopic deployment of multiple (≥ 3) metal stents for unresectable malignant hilar biliary strictures
title_fullStr Endoscopic deployment of multiple (≥ 3) metal stents for unresectable malignant hilar biliary strictures
title_full_unstemmed Endoscopic deployment of multiple (≥ 3) metal stents for unresectable malignant hilar biliary strictures
title_short Endoscopic deployment of multiple (≥ 3) metal stents for unresectable malignant hilar biliary strictures
title_sort endoscopic deployment of multiple (≥ 3) metal stents for unresectable malignant hilar biliary strictures
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499609/
https://www.ncbi.nlm.nih.gov/pubmed/31061879
http://dx.doi.org/10.1055/a-0849-9334
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