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Usefulness of half‐covered metallic stent placement in preventing acute cholecystitis complication in pancreatic cancer‐induced distal biliary stricture
BACKGROUND AND AIM: A self‐expandable metallic stent (SEMS) is commonly used for biliary stricture caused by pancreatic cancer. Covered SEMS may obstruct the cystic duct, causing acute cholecystitis. This study aimed to determine the outcomes of using a half‐covered SEMS with an offset covered porti...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wiley Publishing Asia Pty Ltd
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731833/ https://www.ncbi.nlm.nih.gov/pubmed/33319049 http://dx.doi.org/10.1002/jgh3.12409 |
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author | Takaoka, Makoto Shimatani, Masaaki Ikeura, Tsukasa Mitsuyama, Toshiyuki Miyamoto, Sachi Masuda, Masataka Ito, Takashi Nakamaru, Koh Miyoshi, Hideaki Okazaki, Kazuichi Naganuma, Makoto |
author_facet | Takaoka, Makoto Shimatani, Masaaki Ikeura, Tsukasa Mitsuyama, Toshiyuki Miyamoto, Sachi Masuda, Masataka Ito, Takashi Nakamaru, Koh Miyoshi, Hideaki Okazaki, Kazuichi Naganuma, Makoto |
author_sort | Takaoka, Makoto |
collection | PubMed |
description | BACKGROUND AND AIM: A self‐expandable metallic stent (SEMS) is commonly used for biliary stricture caused by pancreatic cancer. Covered SEMS may obstruct the cystic duct, causing acute cholecystitis. This study aimed to determine the outcomes of using a half‐covered SEMS with an offset covered portion for preventing cystic duct obstruction. METHODS: Among 80 patients with half‐covered SEMS placement for the treatment of pancreatic cancer‐induced distal biliary stricture, 74 were followed up. The half‐covered SEMS has a total length of 6 or 7 cm, and the offset covered part was 0.5–4.5 or 0.5–5.5 cm, respectively. Intraductal ultrasonography (IDUS) and endoscopic nasobiliary drainage (ENBD) were performed during the initial endoscopic retrograde cholangiopancreatography (ERCP). IDUS findings and ENBD tube cholangiogram confirmed the cystic duct confluence. SEMS placement was performed on the second ERCP or several weeks after the initial tube stent placement. RESULTS: Half‐covered SEMS placement was successful in all patients. However, four (5.4%) patients exhibited early complications, including acute cholecystitis in one patient and stent displacement in another. Over 30 days, cholangitis, tumor growth, and stent displacement occurred in nine (11.3%), five (6.3%), and two (2.5%) patients, respectively. The median stent patency was 71.1 weeks, and the median overall survival in patients with and without chemotherapy was 31.8 and 12.2 weeks, respectively. CONCLUSIONS: With confirmation of the cystic duct confluence, half‐covered SEMS placement may become a treatment option for distal biliary stricture caused by pancreatic cancer to prevent acute cholecystitis. Half‐covered SEMS patency was comparable with that of covered SEMS. |
format | Online Article Text |
id | pubmed-7731833 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wiley Publishing Asia Pty Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-77318332020-12-13 Usefulness of half‐covered metallic stent placement in preventing acute cholecystitis complication in pancreatic cancer‐induced distal biliary stricture Takaoka, Makoto Shimatani, Masaaki Ikeura, Tsukasa Mitsuyama, Toshiyuki Miyamoto, Sachi Masuda, Masataka Ito, Takashi Nakamaru, Koh Miyoshi, Hideaki Okazaki, Kazuichi Naganuma, Makoto JGH Open Original Articles BACKGROUND AND AIM: A self‐expandable metallic stent (SEMS) is commonly used for biliary stricture caused by pancreatic cancer. Covered SEMS may obstruct the cystic duct, causing acute cholecystitis. This study aimed to determine the outcomes of using a half‐covered SEMS with an offset covered portion for preventing cystic duct obstruction. METHODS: Among 80 patients with half‐covered SEMS placement for the treatment of pancreatic cancer‐induced distal biliary stricture, 74 were followed up. The half‐covered SEMS has a total length of 6 or 7 cm, and the offset covered part was 0.5–4.5 or 0.5–5.5 cm, respectively. Intraductal ultrasonography (IDUS) and endoscopic nasobiliary drainage (ENBD) were performed during the initial endoscopic retrograde cholangiopancreatography (ERCP). IDUS findings and ENBD tube cholangiogram confirmed the cystic duct confluence. SEMS placement was performed on the second ERCP or several weeks after the initial tube stent placement. RESULTS: Half‐covered SEMS placement was successful in all patients. However, four (5.4%) patients exhibited early complications, including acute cholecystitis in one patient and stent displacement in another. Over 30 days, cholangitis, tumor growth, and stent displacement occurred in nine (11.3%), five (6.3%), and two (2.5%) patients, respectively. The median stent patency was 71.1 weeks, and the median overall survival in patients with and without chemotherapy was 31.8 and 12.2 weeks, respectively. CONCLUSIONS: With confirmation of the cystic duct confluence, half‐covered SEMS placement may become a treatment option for distal biliary stricture caused by pancreatic cancer to prevent acute cholecystitis. Half‐covered SEMS patency was comparable with that of covered SEMS. Wiley Publishing Asia Pty Ltd 2020-09-10 /pmc/articles/PMC7731833/ /pubmed/33319049 http://dx.doi.org/10.1002/jgh3.12409 Text en © 2020 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Takaoka, Makoto Shimatani, Masaaki Ikeura, Tsukasa Mitsuyama, Toshiyuki Miyamoto, Sachi Masuda, Masataka Ito, Takashi Nakamaru, Koh Miyoshi, Hideaki Okazaki, Kazuichi Naganuma, Makoto Usefulness of half‐covered metallic stent placement in preventing acute cholecystitis complication in pancreatic cancer‐induced distal biliary stricture |
title | Usefulness of half‐covered metallic stent placement in preventing acute cholecystitis complication in pancreatic cancer‐induced distal biliary stricture |
title_full | Usefulness of half‐covered metallic stent placement in preventing acute cholecystitis complication in pancreatic cancer‐induced distal biliary stricture |
title_fullStr | Usefulness of half‐covered metallic stent placement in preventing acute cholecystitis complication in pancreatic cancer‐induced distal biliary stricture |
title_full_unstemmed | Usefulness of half‐covered metallic stent placement in preventing acute cholecystitis complication in pancreatic cancer‐induced distal biliary stricture |
title_short | Usefulness of half‐covered metallic stent placement in preventing acute cholecystitis complication in pancreatic cancer‐induced distal biliary stricture |
title_sort | usefulness of half‐covered metallic stent placement in preventing acute cholecystitis complication in pancreatic cancer‐induced distal biliary stricture |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731833/ https://www.ncbi.nlm.nih.gov/pubmed/33319049 http://dx.doi.org/10.1002/jgh3.12409 |
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