Third metal stent for revision of malignant hilar biliary strictures
- Abstract
- Background and study aim: Endoscopic stent-in-stent (SIS) placement of multiple metal stents is technically demanding. In the present study, we explored the technical feasibility and efficacy of endoscopic deployment of a third metal stent to create a triple SIS placement in patients with a bilateral SIS configuration for inoperable high grade malignant hilar biliary stricture (HBS) that had failed clinically. Methods: Eighteen patients with histologically proven inoperable HBS underwent deployment of an additional third metal stent as a revisionary method after early clinical failure following technically successful bilateral SIS placement using cross-wired metal stents. The main outcome measures were the technical and clinical success rates, and adverse events. Results: The overall technical and clinical success rates were 88.9 % (16/18) and 87.5 % (14/16), respectively. The early and late complications were cholangitis (n = 2) and cholecystitis (n = 1). Stent occlusion developed in 35.7 % (5/14) of patients in whom a third metal stent for revision of a bilateral SIS configuration was clinically successful. The median (range) times for stent patency and patient survival were 176 days (49 - 372) and 216 days (52 - 384), respectively. Conclusions: Endoscopic deployment of an additional third metal stent into a bilateral SIS configuration was technically feasible and effective in patients with inoperable high grade malignant HBS in whom bilateral SIS placement had failed clinically.
- All Author(s)
- T. H. Lee
; J. H. Moon
; H. J. Choi
; Y. N. Lee
; M. H. Choi
; S. W. Cha
; Y. D. Cho
; S. H. Park
; S. J. Kim
- Issued Date
- 2016
- Type
- Article
- Keyword
- Aged; Aged, 80 and over; Bile Duct Neoplasms/*complications; Cholangiocarcinoma/*complications; Cholangiopancreatography, Endoscopic Retrograde; Cholangitis/etiology/*surgery; Female; Gallbladder Neoplasms/*complications; Humans; Male; Middle Aged; Palliative Care/*methods; Prosthesis Implantation/*methods; *Self Expandable Metallic Stents
- ISSN
- 0013-726x
- Citation Title
- Endoscopy
- Citation Volume
- 48
- Citation Number
- 12
- Citation Start Page
- 1129
- Citation End Page
- 1133
- Language(ISO)
- eng
- DOI
- 10.1055/s-0042-112574
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2349
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