A novel antireflux metal stent for the palliation of biliary malignancies: a pilot feasibility study (with video)

Novel biliary self-expanding metal stents: indications and applications

“…A pilot study reported outcomes associated with the attachment of an antireflux valve to the end of uncovered and partially covered stents in 23 patients presenting with distal neoplastic biliary obstruction. Serum bilirubin level was restored to normal within 1 month in 87% of the patients (20/23), and median patency rates at 3, 6 and 12 months were, respectively, 95, 74 and 56% [72]. The same authors reported their results from a randomized controlled trial in 104 patients comparing antireflux partially covered metal stents, unfortunately, to uncovered metal stents (instead of partially covered ones) for nonhilar biliary neoplastic strictures.…”

Resolution of pneumobilia as a predictor of biliary stent occlusion

“…The disappearance of biliary gas in an occluded stent is possibly due to excretion of biliary gas with normal bile flow and the stent occlusion preventing reaccumulation via reflux. Currently, antireflux metallic stents have been developed with a valve mechanism to prevent reflux of enteric contents and have a reported patency of N 50% at 12 months [18]. Their antireflux mechanism may prevent the accumulation of biliary gas and it would be important to know if this type of stent was utilized prior to applying our findings.…”

An Update to Hepatobiliary Stents

“…Hu et al examined 23 patients with unresectable nonhilar malignant biliary obstruction and successfully placed antireflux metal stents in all patients. 37 Stent failures occurred for a variety of reasons, including one patient with tumor ingrowth, two with tumor overgrowth, and three with stent migration. Median duration of stent patency was 425 days.…”

“…At 3, 6, and 12 months, 95%, 74%, and 56% of stents, respectively, were patent. 37 In 2012, Hu et al performed another prospective randomized trial with 104 patients. Patency was 505 days in the antireflux stent group (n552) and 301 days in the uncovered metal stent group (n552), and the difference between the two groups was significant (p50.031).…”