Novel endoscopic technique for trisegment drainage in patients with unresectable hilar malignant biliary strictures (with video)
| Autor: | Yuta Maruki, Chigusa Morizane, Yutaka Saito, Takuji Okusaka, Yoshikuni Nagashio, Hideki Ueno, Susumu Hijioka, Shunsuke Kondo, Akihiro Ohba, Shih Yea Sylvia Wu |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Constriction Pathologic 03 medical and health sciences 0302 clinical medicine Self-expandable metallic stent Medicine Humans Radiology Nuclear Medicine and imaging In patient Drainage Adverse effect Retrospective Studies Cholestasis business.industry Gastroenterology Stent equipment and supplies medicine.disease Surgery surgical procedures operative Treatment Outcome Bile Duct Neoplasms 030220 oncology & carcinogenesis Cholecystitis 030211 gastroenterology & hepatology Stents Delivery system business Liver abscess |
| Zdroj: | Gastrointestinal endoscopy. 92(3) |
| ISSN: | 1097-6779 |
| Popis: | Three or more stents may be needed in patients with extensive stricturing in Bismuth type IIIa/IV hilar malignant strictures. Partial stent-in-stent (PSIS) deployment has been the primary intervention for hilar malignant biliary stricture (MBS). However, simultaneous side-by-side (SBS) stent placement has become feasible with the development of the 6F diameter stent delivery system. Our aim was to assess the efficacy and safety of a new hybrid method combining PSIS and SBS stent placement for trisegment biliary drainage.This study included 17 consecutive patients with Bismuth IIIa or IV malignant strictures who underwent endoscopic drainage using the hybrid method. Diameters of the delivery stents were 5.4F (n = 10) and 5.7F (n = 7).The technical success rate was 82% (14/17), and the median length of procedures was 54 minutes. Two patients required predilatation for deployment of the third self-expandable metallic stent through the mesh of the first deployed stent. Two patients (12%) developed cholecystitis as early adverse events, and 1 patient (6%) developed liver abscess as a late adverse event. The time to recurrent biliary obstruction among those with successful initial trisegmental drainage was 189 days (95% confidence interval, 124-254).The hybrid method for unresectable hilar MBS is an effective endoscopic drainage method, and the ease of these procedures is partly attributed to the thinner stent delivery system. |
| Databáze: | OpenAIRE |
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