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Journal of Hepato-Biliary-Pancreatic Sciences

Published in:

01-09-2011 | Topics

Endoscopic bilateral metallic stenting for malignant hilar obstruction using newly designed stents

Authors: Hirofumi Kogure, Hiroyuki Isayama, Kazumichi Kawakubo, Takashi Sasaki, Natsuyo Yamamoto, Kenji Hirano, Naoki Sasahira, Takeshi Tsujino, Minoru Tada, Kazuhiko Koike

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

Abstract

Background/Purpose

Whether unilateral or bilateral drainage should be performed for malignant hilar biliary obstruction is controversial. Moreover, endoscopic placement of bilateral metallic stents is difficult and complicated.

Methods

New metallic stents, such as the Niti-S Y-type stent (Y-stent), BONASTENT M-Hilar, and Niti-S large cell D-type stent (LCD), have recently been developed for bilateral stent-in-stent procedures to facilitate contralateral stent deployment through the interstices of the first metallic stent. We review the features and efficacy of these metallic stents designed for bilateral drainage in patients with hilar biliary obstruction.

Results

The newly designed stents examined exhibited high technical success rates, low stent-related complications, and good stent patency. Endoscopic reinterventions for occluded stents could be performed easily, particularly in patients with bilateral LCD placement.

Conclusion

Endoscopic bilateral stenting using newly designed metallic stents is feasible, safe, and effective in patients with unresectable malignant hilar biliary obstruction.

Chang WH, Kortan P, Haber GB. Outcome in patients with bifurcation tumors who undergo unilateral versus bilateral hepatic duct drainage. Gastrointest Endosc. 1998;47:354–62.PubMedCrossRef

De Palma GD, Galloro G, Siciliano S, Iovino P, Catanzano C. Unilateral versus bilateral endoscopic hepatic duct drainage in patients with malignant hilar biliary obstruction: results of a prospective, randomized, and controlled study. Gastrointest Endosc. 2001;53:547–53.PubMedCrossRef

De Palma GD, Pezzullo A, Rega M, Persico M, Patrone F, Mastantuono L, et al. Unilateral placement of metallic stents for malignant hilar obstruction: a prospective study. Gastrointest Endosc. 2003;58:50–3.PubMedCrossRef

Deviere J, Baize M, de Toeuf J, Cremer M. Long-term follow-up of patients with hilar malignant stricture treated by endoscopic internal biliary drainage. Gastrointest Endosc. 1988;34:95–101.PubMedCrossRef

Hookey LC, Le Moine O, Deviere J. Use of a 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

Polydorou AA, Chisholm EM, Romanos AA, Dowsett JF, Cotton PB, Hatfield AR, et al. A comparison of right versus left hepatic duct endoprosthesis insertion in malignant hilar biliary obstruction. Endoscopy. 1989;21:266–71.PubMedCrossRef

Sherman S. Endoscopic drainage of malignant hilar obstruction: is one biliary stent enough or should we work to place two? Gastrointest Endosc. 2001;53:681–4.PubMedCrossRef

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

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

10.

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

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. Y-shaped endoscopic bilateral metal stent placement for malignant hilar biliary obstruction: prospective long-term study. Scand J Gastroenterol. 2011;46:326–32.PubMedCrossRef

13.

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.PubMedCrossRef

14.

Park DH, Lee SS, Moon JH, Choi HJ, Cha S-W, 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

15.

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. 2010;25:463–7.PubMedCrossRef

16.

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

Title: Endoscopic bilateral metallic stenting for malignant hilar obstruction using newly designed stents
Authors: Hirofumi Kogure
Hiroyuki Isayama
Kazumichi Kawakubo
Takashi Sasaki
Natsuyo Yamamoto
Kenji Hirano
Naoki Sasahira
Takeshi Tsujino
Minoru Tada
Kazuhiko Koike
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/s00534-011-0407-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endoscopic bilateral metallic stenting for malignant hilar obstruction using newly designed stents

Abstract

Background/Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background/Purpose

Methods

Results

Conclusion

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