Jun 2, 2009

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)

Gastrointestinal Endoscopy
Do Hyun ParkMyung-Hwan Kim


Endoscopic management of malignant hilar biliary strictures is difficult even for an experienced endoscopist. Moreover, endoscopic placement of bilateral metal stents is considered very difficult and complicated. We explored the feasibility and efficacy of the placement of a newly designed metal stent for an endoscopic bilateral stent-in-stent procedure for the management of malignant hilar biliary strictures. Multicenter prospective feasibility study. Five academic tertiary referral centers. Thirty-five patients with malignant hilar biliary strictures of Bismuth type II or higher were enrolled. Bilateral stent placement by an endoscopic stent-in-stent procedure. Technical success, functional success, early and late complications, stent patency. The overall technical success rate of the newly designed metal stent was 94.3% (33/35). The success rate of the stent-in-stent procedure in a single session was 82% (27/33) per protocol and 77% (27/35) as intent to treat. In cases in which the initial stent-in-stent procedure failed, patients underwent the endoscopic stent-in-stent procedure for contralateral stent placement at 2 days (6%, 2/33) or 4 days (12%, 4/33) after the initial stent placement. There was no percutaneous insertion...Continue Reading

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Mentioned in this Paper

Endoscopy (Procedure)
Entire Right Hepatic Duct
Stent, Device
Structure of Right Hepatic Duct
Body Cavities
Bismuth preparation
Dental Caries
Malignant Paraganglionic Neoplasm
Stent Occlusion

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