A Novel Double Stent System for Palliative Treatment of Malignant Extrahepatic Biliary Obstructions: A Pilot Study

Gwon, Dong Il; Ko, Gi Young; Sung, Kyu Bo; Yoon, Hyun Ki; Shin, Ji Hoon; Kim, Jin Hyoung; Kim, Jinoo; Oh, Ji Young; Song, Ho Young

doi:10.2214/ajr.11.6813

Cited by 10 publications

(11 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our present multicenter assessment of the double stent system, stent deployment was technically successful in all patients. Our study expands upon results from an initial smaller pilot study evaluating the double stent (16) by utilizing a larger patient population from four different centers. Not only does the current study re-establish encouraging results (median patient survival and stent patency time of 135 and 114 days, respectively), new potential complications (namely cholecystitis and pancreatitis) are also elucidated.…”

Section: Discussionmentioning

confidence: 89%

“…Patients were eligible for enrollment if they had extrahepatic biliary obstructions caused by malignancies that could not be treated surgically (due to unresectability, late tumor stage, advanced age, or co-morbidity), and if endoscopic attempts to drain obstructed bile ducts were unsuccessful. Exclusion criteria included abnormal coagulation status (platelet count ≤50,000 and international normalized ratio value ≥1.5) and poor general health status (16) (Eastern Cooperative Oncology Group [ECOG] performance status grade 3–4) because of inherently poor survival.…”

Section: Methodsmentioning

confidence: 99%

“…Previously, Gwon et al. (16), in a pilot study of 45 patients, introduced a double stent system for reducing these potential problems. While the results of that initial study were promising, a larger study was warranted to further evaluate the benefits and potential complications of the double stent system.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A prospective, multicenter study of a double stent system for palliative treatment of malignant extrahepatic biliary obstructions

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

A prospective, multicenter study of a double stent system for palliative treatment of malignant extrahepatic biliary obstructions

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…Clinical success was defined as decreased serum bilirubin to <75% of pretreatment values within 1 month after stent placement. [ 16 ] Complications were considered major or minor according to guidelines of the Society of Interventional Radiology Standards of Practice Committee. [ 17 ]…”

Section: Methodsmentioning

confidence: 99%

Differences in efficacy of uncovered self-expandable metal stent in relation to placement in the management of malignant distal biliary obstruction

Zhang

Liu

et al. 2018

Saudi J Gastroenterol

View full text Add to dashboard Cite

Background/Aims:Metal stent insertion is a common palliative treatment for distal malignant biliary obstruction (MBO) but whether placement across the sphincter of Oddi (SO) causes more complications or shorter survival is in question. The aim of this study was to compare the clinical outcomes of percutaneous uncovered self-expandable metal stent placement above and across the SO in patients with distal MBO.Patients and Methods:We retrospectively studied 59 patients who underwent uncovered metal stent placement for distal MBO between January 2012 and March 2016. Stents were placed above the SO for 22 subjects (group A) and across the SO for 37 subjects (group B). Early cholangitis, stent occlusion, and overall survival time were compared between the two groups.Results:Clinical success was 90.9 and 86.5% for groups A and B, respectively. Early cholangitis occurred in 2 patients (9.1%) in group A and in 6 patients (16.2%) in group B (P = 0.645). Median stent patency and median survival time was 105 and 140 days for group A, 120 and 160 days for group B, respectively. The stent occlusion (31.8% in group A and 21.6% in group B, P = 0.454) and the cumulative stent patency times (P = 0.886) did not differ between the two groups. There was no significant difference in cumulative patient survival between the two groups (P = 0.810).Conclusion:Uncovered metal stent placement across the SO did not significantly affect early cholangitis, stent patency, or patient survival.

show abstract

“…Recently, the use of polytetrafluoroethylene (PTFE)-covered stents has been found to be an effective treatment method, with the PTFE material serving as an effective barrier to prevent tumor ingrowth. [30][31][32][33] In one comparative study of PTFE-covered and uncovered stents, 34 PTFE-covered stents were significantly superior to uncovered stents in terms of stent patency. In general, one important limitation in using covered stent for treatment of malignant hilar biliary obstruction is a risk of occlusion of branching intrahepatic bile duct.…”

Section: Percutaneous Covered Biliary Stent Placementmentioning

confidence: 99%

Interventional radiologic approach to hilar malignant biliary obstruction

Gwon

2016

Int J Gastrointest Interv

Self Cite

View full text Add to dashboard Cite

Biliary obstruction due to advanced hepatic hilar malignancy is difficult to treat, both surgically and non-surgically, using endoscopic or percutaneous drainage. Since only about 10% to 20% of patients are eligible for resection of hepatic hilar malignancies, most patients receive palliative rather than curative treatment. Percutaneous palliation of advanced hepatic hilar malignancies can be accomplished in a variety of ways. Percutaneous bilateral metallic stent placement may be a reasonable option in patients with hilar malignancies to preserve the functional volume of the liver during the course of chemotherapy and to prevent procedure-related cholangitis of a contaminated undrained lobe. Percutaneous bilateral stent-in-stent placement using wide-mesh or open-cell design stents is a feasible and effective method of achieving bilateral drainage. Moreover, unilateral covered or uncovered metallic stent placement in the lobe with patent portal vein is safe and effective method for palliative treatment in patients with contralateral portal vein occlusion caused by hilar malignancies, obviating the need for bilateral stent placement in these patients.

show abstract

A Novel Double Stent System for Palliative Treatment of Malignant Extrahepatic Biliary Obstructions: A Pilot Study

Abstract: Preliminary results indicate that percutaneous treatment of malignant extrahepatic biliary obstructions using a novel double stent is feasible, safe, and effective in achieving internal biliary drainage.

Cited by 10 publications

References 28 publications

A prospective, multicenter study of a double stent system for palliative treatment of malignant extrahepatic biliary obstructions

A prospective, multicenter study of a double stent system for palliative treatment of malignant extrahepatic biliary obstructions

Differences in efficacy of uncovered self-expandable metal stent in relation to placement in the management of malignant distal biliary obstruction

Interventional radiologic approach to hilar malignant biliary obstruction

Contact Info

Product

Resources

About