Efficacy and complications of covered Wallstents in malignant distal biliary obstruction

Kahaleh, Michel; Tokar, Jeffrey L.; Conaway, Mark R.; Brock, Andrew; Le, Tri Minh; Adams, Reid B.; Yeaton, Paul

doi:10.1016/s0016-5107(04)02593-3

Cited by 161 publications

(128 citation statements)

References 30 publications

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“…More cautious treatment such as prolonging hospitalization days, close observation, and regular imaging studies are needed for these patients. In the study by Kahaleh et al, 10 the frequency of cholecystitis was 3.8%, which was lower than the result of our study. The investigators had taken empiric steps to reduce adverse events by routinely performing GB lavage through the cystic duct.…”

Section: Discussioncontrasting

confidence: 87%

“…[1][2][3][4] As a result of advancements in therapeutic ERCP and the development of a variety of metal stents, [5][6][7][8][9] complications after stent procedures, although not frequent, are being increasingly identified. 10 Moreover, these complications, including migration of stent, cholangitis, pancreatitis, cholecystitis, and obstruction of the stent, may prove fatal to patients with a short life expectancy. In particular, cholecystitis has been reported in as many as 1.9% 11 to 12% 9 of cases.…”

mentioning

confidence: 99%

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Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Suk

Kim

et al. 2006

Gastrointestinal Endoscopy

141

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Section: Discussioncontrasting

confidence: 87%

mentioning

confidence: 99%

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Suk

Kim

et al. 2006

Gastrointestinal Endoscopy

141

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“…This result depends on several circumstances since partially covered SEMS can also become occluded as a result of tumor growth or granulation tissue through the spaces in the stent's ends in 12% to 14% of cases (3,11,12). In our groups, clinical success according to the protocol of covered and uncovered SEMS was 95.5% and 87%, respectively, and there was no statistically significant difference in terms of biochemical parameter decreases.…”

Section: Discussionmentioning

confidence: 61%

Comparison of covered and uncovered self-expandable stents in the treatment of malignant biliary obstruction

Carmona¹,

Lárraga²,

Guerrero³

et al. 2016

Rev Esp Enferm Dig

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Background and objective: Drainage with metallic stents is the treatment of choice in malignant obstructive jaundice. Technical and clinical success with metallic stents is obtained in over 90% and 80% of cases, respectively. There are self-expandable metallic stents designed to increase permeability. The aim of this study was to describe the results obtained with totally covered self-expandable and uncovered self-expandable metallic stents in the palliative treatment of malignant biliary obstruction.Patients and methods: Sixty eight patients with malignant obstructive jaundice secondary to pancreatobiliary or metastatic disease not amenable to surgery were retrospectively included. Two groups were created: group A (covered self-expandable metallic stents) (n = 22) and group B (uncovered self-expandable metallic stents) (n = 46).Results: Serum total bilirubin, direct bilirubin, alkaline phosphatase and gamma glutamyl transferase levels decreased in both groups and no statistically significant difference was detected (p = 0.800, p = 0.190, p = 0.743, p = 0.521). Migration was greater with covered stents but it was not statistically significant either (p = 0.101). Obstruction was greater in the group with uncovered stents but it was not statistically significant either (p = 0.476).Conclusion: There are no differences when using covered self-expandable stents or uncovered self-expandable stents in terms of technical and clinical success or complications in the palliative treatment of malignant obstructive jaundice.

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“…Different design alternatives have been explored in an attempt to improve stent patency. Covered SEMS were designed to prevent tissue ingrowth; however, they are contra-indicated for hilar drainage, have higher migration rates, and might be associated with increased risks of pancreatitis and cholecystitis [6][7][8][9][10][11]. Another treatment strategy to prolong stent patency and eventual survival is photodynamic therapy (PDT).…”

Section: Introductionmentioning

confidence: 99%

387 Safety and Efficacy of Radiofrequency Ablation in the Management of Unresectable Bile Duct and Pancreatic Cancer: A Novel Palliation Technique

Figueroa-Barojas

Bakhru

Habib

et al. 2011

Gastrointestinal Endoscopy

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Objectives. Radiofrequency ablation (RFA) has replaced photodynamic therapy for premalignant and malignant lesions of the esophagus. However, there is limited experience in the bile duct. The objective of this pilot study was to assess the safety and efficacy of RFA in malignant biliary strictures. Methods: Twenty patients with unresectable malignant biliary strictures underwent RFA with stenting between June 2010 and July 2012. Diameters of the stricture before and after RFA, immediate and 30 day complications and stent patency were recorded prospectively. Results. A total of 25 strictures were treated. Mean stricture length treated was 15.2 mm (SD = 8.7 mm, Range = 3.5-33 mm). Mean stricture diameter before RFA was 1.7 mm (SD = 0.9 mm, Range = 0.5-3.4 mm) while the mean diameter after RFA was 5.2 mm (SD = 2 mm, Range = 2.6-9 mm). There was a significant increase of 3.5 mm (t = 10.8, DF = 24, P value = <.0001) in the bile duct diameter post RFA. Five patients presented with pain after the procedure, but only one developed mild post-ERCP pancreatitis and cholecystitis. Conclusions: Radiofrequency ablation can be a safe palliation option for unresectable malignant biliary strictures. A multicenter randomized controlled trial is required to confirm the long term benefits of RFA and stenting compared to stenting alone.

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Efficacy and complications of covered Wallstents in malignant distal biliary obstruction

Cited by 161 publications

References 30 publications

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

Comparison of covered and uncovered self-expandable stents in the treatment of malignant biliary obstruction

387 Safety and Efficacy of Radiofrequency Ablation in the Management of Unresectable Bile Duct and Pancreatic Cancer: A Novel Palliation Technique

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