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Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report

BACKGROUND: Uncovered stents used for malignant obstructions in the biliary tree, especially in the hilar area, are prone to obstruction by tumor ingrowths. In comparison, however, covered stents may block bile duct branches and are at risk of migration. We have developed a multi-hole self-expandabl...

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Autor principal: Kobayashi, Makoto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580344/
https://www.ncbi.nlm.nih.gov/pubmed/31236396
http://dx.doi.org/10.12998/wjcc.v7.i11.1323
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author Kobayashi, Makoto
author_facet Kobayashi, Makoto
author_sort Kobayashi, Makoto
collection PubMed
description BACKGROUND: Uncovered stents used for malignant obstructions in the biliary tree, especially in the hilar area, are prone to obstruction by tumor ingrowths. In comparison, however, covered stents may block bile duct branches and are at risk of migration. We have developed a multi-hole self-expandable metallic stent (MHSEMS), with a hole in each cell, to prevent the obstruction of bile duct branches. In addition, the holes may prevent migration due to small ingrowths by reducing the tension of the membrane. CASE SUMMARY: MHSEMS were placed in five patients with a malignant obstruction and one with post-endoscopic sphincterotomy bleeding. Each MHSEMS was successfully deployed in all cases. Patients showed no complications. Two cases were reviewed. Case 1: A 74-year-old male presented with jaundice and was diagnosed with a sigmoid colon cancer and giant liver metastases in the right liver lobe. A MHSEMS was placed in the left bile duct. The jaundice improved and peroral cholangioscopy was performed. Case 2: A 90-year-old female was admitted to hospital for jaundice and diagnosed with cholangiocarcinoma. A MHSEMS was placed in the left bile duct but after 8 months the stent became obstructed by tumor ingrowth. We treated the patient by ablation therapy. A silicone cover separated the internal bile duct from the surrounding tissue, protecting the latter from thermal injury during treatment by endobiliary ablation of the re-obstruction. CONCLUSION: A MHSEMS is a new choice of stent for biliary tract diseases.
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spelling pubmed-65803442019-06-24 Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report Kobayashi, Makoto World J Clin Cases Case Report BACKGROUND: Uncovered stents used for malignant obstructions in the biliary tree, especially in the hilar area, are prone to obstruction by tumor ingrowths. In comparison, however, covered stents may block bile duct branches and are at risk of migration. We have developed a multi-hole self-expandable metallic stent (MHSEMS), with a hole in each cell, to prevent the obstruction of bile duct branches. In addition, the holes may prevent migration due to small ingrowths by reducing the tension of the membrane. CASE SUMMARY: MHSEMS were placed in five patients with a malignant obstruction and one with post-endoscopic sphincterotomy bleeding. Each MHSEMS was successfully deployed in all cases. Patients showed no complications. Two cases were reviewed. Case 1: A 74-year-old male presented with jaundice and was diagnosed with a sigmoid colon cancer and giant liver metastases in the right liver lobe. A MHSEMS was placed in the left bile duct. The jaundice improved and peroral cholangioscopy was performed. Case 2: A 90-year-old female was admitted to hospital for jaundice and diagnosed with cholangiocarcinoma. A MHSEMS was placed in the left bile duct but after 8 months the stent became obstructed by tumor ingrowth. We treated the patient by ablation therapy. A silicone cover separated the internal bile duct from the surrounding tissue, protecting the latter from thermal injury during treatment by endobiliary ablation of the re-obstruction. CONCLUSION: A MHSEMS is a new choice of stent for biliary tract diseases. Baishideng Publishing Group Inc 2019-06-06 2019-06-06 /pmc/articles/PMC6580344/ /pubmed/31236396 http://dx.doi.org/10.12998/wjcc.v7.i11.1323 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Kobayashi, Makoto
Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report
title Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report
title_full Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report
title_fullStr Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report
title_full_unstemmed Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report
title_short Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report
title_sort development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580344/
https://www.ncbi.nlm.nih.gov/pubmed/31236396
http://dx.doi.org/10.12998/wjcc.v7.i11.1323
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