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Journal of Hepato-Biliary-Pancreatic Sciences

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01-09-2011 | Topics

Comparison of axial force and cell width of self-expandable metallic stents: which type of stent is better suited for hilar biliary strictures?

Authors: Tsuyoshi Mukai, Ichiro Yasuda, Hiroyuki Isayama, Masanori Nakashima, Shinpei Doi, Takuji Iwashita, Keisuke Iwata, Tomohiro Kato, Eiichi Tomita, Hisataka Moriwaki

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 5/2011

Abstract

Background

Various types of self-expandable metallic stents (SEMSs) are commercially available. However, few reports have compared the performance of the various SEMSs. In addition to long-term patency, maneuverability during initial placement and feasibility of re-intervention for the stent occlusion are also very important.

Methods

In this retrospective analysis, we compared the duration of stent patency and frequency of re-interventions in 96 patients diagnosed with unresectable hilar biliary strictures in whom initial 10-mm SEMSs were inserted between June 1999 and November 2008.

Results

Based on Kaplan–Meier curves, significantly shorter patency duration was noted for SEMSs with moderate axial force (AF) than for other groups of SEMSs with low AF. Endoscopic re-interventions for SEMS occlusion were easier in a group of SEMSs with low AF and large cell width than in other groups of SEMSs.

Conclusions

With respect to patency duration and the frequency of re-intervention required, we consider that SEMSs with low AF and large cell width are favorable for hilar biliary strictures.

Paik WH, Park YS, Hwang JH, Lee SH, Yoon CJ, Kang SG, et al. Palliative treatment with self-expandable metallic stents in patients with advanced type III or IV hilar cholangiocarcinoma: a percutaneous versus endoscopic approach. Gastrointest Endosc. 2009;69:55–62.PubMedCrossRef

Ferreira LE, Baron TH. Endoscopic stenting for palliation of malignant biliary obstruction. Expert Rev Med Devices. 2010;7:681–91.PubMedCrossRef

Jeong YW, Shin KD, Kim SH, Kim IH, Kim SW, Lee KA, et al. The safety assessment of percutaneous transhepatic transpapillary stent insertion in malignant obstructive jaundice: regarding the risk of pancreatitis and the effect of preliminary endoscopic sphincterotomy. Korean J Gastroenterol. 2009;54:390–4 (in Korean with English abstract).

Lee JH, Kang DH, Kim JY, Lee SM, Kim DH, Park CW, et al. Endoscopic bilateral metal stent placement for advanced hilar cholangiocarcinoma: a pilot study of a newly designed Y stent. Gastrointest Endosc. 2007;66:364–9.PubMedCrossRef

Park DH, Lee SS, Moon JH, Choi HJ, Cha SW, Kim JH, et al. Newly designed stent for endoscopic bilateral stent-in-stent placement of metallic stents in patients with malignant hilar biliary strictures: multicenter prospective feasibility study (with videos). Gastrointest Endosc. 2009;69:1357–60.PubMedCrossRef

Kawamoto H, Tsutsumi K, Harada R, Fujii M, Kato H, Hirao K, et al. Endoscopic deployment of multiple JOSTENT SelfX is effective and safe in treatment of malignant hilar biliary strictures. Clin Gastroenterol Hepatol. 2008;6:401–8.PubMedCrossRef

Naitoh I, Ohara H, Nakazawa T, Ando T, Hayashi K, Okumura F, et al. Unilateral versus bilateral endoscopic metal stenting for malignant hilar biliary obstruction. J Gastroenterol Hepatol. 2009;24:552–7.PubMedCrossRef

Silverman W, Slivka A. New technique for bilateral metal mesh stent insertion to treat hilar cholangiocarcinoma. Gastrointest Endosc. 1996;43:61–3.PubMed

Gerhardt T, Rings D, Höblinger A, Heller J, Sauerbruch T, Schepke M. Combination of bilateral metal stenting and trans-stent photodynamic therapy for palliative treatment of hilar cholangiocarcinoma. Z Gastroenterol. 2010;48:28–32.PubMedCrossRef

10.

Chahal P, Baron TH. Expandable metal stents for endoscopic bilateral stent-within-stent placement for malignant hilar biliary obstruction. Gastrointest Endosc. 2010;71:195–9.PubMedCrossRef

11.

Kim JY, Kang DH, Kim HW, Choi CW, Kim ID, Hwang JH, et al. Usefulness of slimmer and open-cell-design stents for endoscopic bilateral stenting and endoscopic revision in patients with hilar cholangiocarcinoma (with video). Gastrointest Endosc. 2009;70:1109–15.PubMedCrossRef

12.

Hwang JC, Kim JH, Lim SG, Kim SS, Yoo BM, Cho SW, et al. Y-shaped endoscopic bilateral metal stent placement for malignant hilar biliary obstruction: prospective long-term study. Scand J Gastroenterol. 2011;46:326–32.

13.

Kogure H, Isayama H, Nakai Y, Tsujino T, Ito Y, Yamamoto K, et al. Newly designed large cell Niti-S stent for malignant hilar biliary obstruction: a pilot study. Surg Endosc. 2011;25:463–7.

14.

Kanno Y, Ito K, Fujita N, Noda Y, Kobayashi G, Obana T, et al. Single-session endoscopic bilateral y-configured placement of metal stents for hilar malignant biliary obstruction. Dig Endosc. 2011;23:91–6.

15.

Isayama H, Nakai Y, Toyokawa Y, Togawa O, Gon C, Ito Y, et al. Measurement of radial and axial forces of biliary self-expandable metallic stents. Gastrointest Endosc. 2009;70:37–44.PubMedCrossRef

16.

Wagner HJ, Knyrim K, Vakil N, Klose KJ. Plastic endoprosthesis versus metal stents in the palliative treatment of malignant hilar biliary obstruction. A prospective and randomized trial. Endoscopy. 1993;25:213–8.PubMedCrossRef

17.

Dumas R, Demuth N, Buckley M, Peten EP, Manos T, Demarquay JF, et al. Endoscopic bilateral metal stent placement for malignant hilar stenoses: identification of optimal technique. Gastrointest Endosc. 2000;51:334–8.PubMedCrossRef

18.

Cheng JL, Bruno MJ, Bergman JJ, Rauws EA, Tytgat GN, Huibregtse K. Endoscopic palliation of patients with biliary obstruction caused by nonresectable hilar cholangiocarcinoma: efficacy of self-expandable metallic Wallstents. Gastrointest Endosc. 2002;56:33–9.PubMedCrossRef

19.

Hookey LC, Le Moine O, Deviere J. Use of temporary plastic stent to facilitate the placement of multiple self-expanding metal stents in malignant biliary hilar strictures. Gastrointest Endosc. 2005;62:605–9.PubMedCrossRef

20.

Chen JH, Sun CK, Liao CS, Chua CS. Self-expandable metallic stents for malignant biliary obstruction: Efficacy on proximal and distal tumors. World J Gastroenterol. 2006;12:119–22.PubMed

21.

Saleem A, Baron TH, Gostout CJ. Large-diameter therapeutic channel duodenoscope to facilitate simultaneous development of side-by-side self-expandable metal stents in hilar cholangiocarcinoma. Gastrointest Endosc. 2010;72:628–31.PubMedCrossRef

22.

Chennat J, Waxman I. Initial performance profile of a new 6F self-expanding metal stent for palliation of malignant hilar biliary obstruction. Gastrointest Endosc. 2010;72:632–6.PubMedCrossRef

Title: Comparison of axial force and cell width of self-expandable metallic stents: which type of stent is better suited for hilar biliary strictures?
Authors: Tsuyoshi Mukai
Ichiro Yasuda
Hiroyuki Isayama
Masanori Nakashima
Shinpei Doi
Takuji Iwashita
Keisuke Iwata
Tomohiro Kato
Eiichi Tomita
Hisataka Moriwaki
Publication date: 01-09-2011
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 5/2011
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-011-0406-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of axial force and cell width of self-expandable metallic stents: which type of stent is better suited for hilar biliary strictures?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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