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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
© Georg Thieme Verlag KG
2019
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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. |
format | Online Article Text |
id | pubmed-6499609 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | © Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
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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