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J Hepatobiliary Pancreat Sci. 2016 Sep;23(9):548-55. doi: 10.1002/jhbp.372. Epub 2016 Aug 1.

Benefits of side-by-side deployment of 6-mm covered self-expandable metal stents for hilar malignant biliary obstructions.

Author information

1
Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa Ward, Nagoya, Aichi, 464-0021, Japan.
2
Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa Ward, Nagoya, Aichi, 464-0021, Japan. khara@aichi-cc.jp.
3
Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.

Abstract

BACKGROUND:

The best way to perform endoscopic stenting for hilar malignant biliary obstruction (HMBO) is under discussion. Recently, a 6-mm covered self-expandable metal stent (CSEMS) has become available. In this article, the results of side-by-side (SBS) 6-mm CSEMS deployment for HMBO are reported.

METHODS:

A total of 22 patients, 32 procedures of SBS 6-mm CSEMS [16 fully covered (FCSEMS), 16 partially covered (PCSEMS)] deployment for HMBO, were prospectively enrolled from November 2011 to June 2015 and retrospectively analyzed. Technical and clinical success rates, stent patency period, complications, and re-intervention success rates were analyzed.

RESULTS:

The overall/FCSEMS/PCSEMS technical and clinical success rates were 96.9%/93.8%/100% and 93.5%/100%/87.5%, respectively. The mean stent patency period was 95/113/68 days. Early and late complication rates were 3.1%/0%/6.3% and 6.3%/12.5%/0%, respectively. Stent exchange was attempted in 12 procedures, and the stent exchange success rate was 83.3%/100%/75%.

CONCLUSIONS:

This is the first report of SBS 6-mm CSEMS deployment for HMBO. This procedure has high technical and clinical success rates and the advantages of ease of performance and a high success rate of re-intervention. Outcomes appear better with FCSEMS than with PCSEMS deployment. Since stent patency is still controversial, large-sample studies are needed.

KEYWORDS:

Biliary tract neoplasms; Cholangiopancreatography; Endoscopic retrograde; Palliative care; Stents

PMID:
27345771
DOI:
10.1002/jhbp.372
[Indexed for MEDLINE]

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