Endoscopic biliary stenting for unresectable malignant hilar obstruction

Fukasawa, Mitsuharu; Takano, Shinichi; Shindo, Hiroko; Takahashi, Ei; Satô, Tadashi; Enomoto, Nobuyuki

doi:10.1007/s12328-017-0778-4

Cited by 32 publications

(26 citation statements)

References 31 publications

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“…First, the Y-shaped configuration resulting from the use of SIS is more physiological; SIS requires less axial force and exerts less pressure on the proximal and distal bile duct wall and surrounding vascular structures. 73 Second, because the distal end of the stent is usually placed above the level of the papilla, it may prevent duodenal reflux and depositing of organic material or bacteria, which can lead to sludge or stone formation within the stent. Third, multi-sectoral drainage for primary stent insertion or revision is possible with SIS deployment.…”

Section: Advantages and Disadvantages Of Bilateral Sis And Sbs Deploymentioning

confidence: 99%

Biliary stenting for hilar malignant biliary obstruction

Lee

Moon

Park

2019

Digestive Endoscopy

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Although endoscopic intervention is the mainstay for palliation of malignant biliary obstruction, a percutaneous approach has been preferred, particularly in patients with advanced highgrade hilar malignant biliary obstruction, because of the technical difficulty and risk of complications. However, recently, primary endoscopic palliation using plastic or metal stents has had higher technical and clinical success with fewer adverse events than the percutaneous approach. Endoscopic interventions are being done more and more frequently because of advances in metal stents, accessories, and techniques.However, several concerns, such as optimal stent type, number, and deployment method, remain to be resolved. Therefore, we reviewed the literature in order to identify the optimal biliary stenting strategy for patients with hilar malignant biliary obstruction, focusing on stent type (plastic vs metal), number (unilateral [single] vs bilateral [multiple]), and deployment method (stent-in-stent vs stent-by-stent). NA, not available; NS, not significant; RCT, randomized controlled trial; SEMS, self-expandable metal stent. † 30-day mortality. ‡ Six-month patency rate. Digestive Endoscopy 2020; 32: 275-286 Biliary stenting for HMBO 277 157 180 26 Kawakubo et al. 70 SBS Zilver 84.6 (11/13) NA 38 (5/13) 263 206 194 NA, not available; SBS, stent-by-stent; SEMS, self-expandable metal stents; SIS, stent-in-stent. Digestive Endoscopy 2020; 32: 275-286 Biliary stenting for HMBO 281 Digestive Endoscopy 2020; 32: 275-286 Biliary stenting for HMBO 285

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Section: Advantages and Disadvantages Of Bilateral Sis And Sbs Deploymentioning

confidence: 99%

Biliary stenting for hilar malignant biliary obstruction

Lee

Moon

Park

2019

Digestive Endoscopy

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“…However, endoscopic approach of CCC types IIIa, IIIb or IV is very challenging and superior results with less infectious complications can be obtained with PTBD (124,125) . Drainage of more than 50% of the liver volume was previously related to effective palliation and is considered the optimal goal when treating malignant biliary strictures (106,128,129) . However, this goal usually requires bilateral stenting, increasing the complexity of the procedure.…”

Section: Malignant Biliary Stricturementioning

confidence: 99%

Recommendations for Invasive Procedures in Patients With Diseases of the Liver and Biliary Tract: Report of a Joint Meeting of the Brazilian Society of Hepatology (Sbh), Brazilian Society of Digestive Endoscopy (Sobed) and Brazilian Society of Interventional Radiology and Endovascular Surgery (Sobrice)

Schiavon

Ejima

Menezes

et al. 2019

Arq. Gastroenterol.

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Liver and biliary tract diseases are common causes of morbidity and mortality worldwide. Invasive procedures are usually performed in those patients with hepatobiliary diseases for both diagnostic and therapeutic purposes. Defining proper indications and restraints of commonly used techniques is crucial for proper patient selection, maximizing positive results and limiting complications. In 2018, the Brazilian Society of Hepatology (SBH) in cooperation with the Brazilian Society of Interventional Radiology and Endovascular surgery (SOBRICE) and the Brazilian Society of Digestive Endoscopy (SOBED) sponsored a joint single-topic meeting on invasive procedures in patients with hepatobiliary diseases. This paper summarizes the proceedings of the aforementioned meeting. It is intended to guide clinicians, gastroenterologists, hepatologists, radiologists, and endoscopists for the proper use of invasive procedures for management of patients with hepatobiliary diseases.

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“…The optimal strategy of biliary drainage is guided by the level of obstruction and degree of involvement of biliary ducts in the hilum, which has conventionally been described using the Bismuth–Corlette classification (Figure ). Biliary drainage in hilar lesions is further complicated by the possibility of retained contrast or sequestered bile in obstructed biliary segments as well as the necessity to preserve liver function . Before endoscopic drainage of hilar MBTO, preprocedural planning should include cross‐sectional imaging to identify sites and extent of biliary obstruction as well as lobar atrophy.…”

Section: Malignant Hilar Obstructionmentioning

confidence: 99%

“…SBS stent placement is technically easier as guidewires can be inserted into right and left hepatic ducts to direct stent placement. SIS stent placement is more technically challenging but can prevent excessive expansion seen in the SBS technique, which can lead to overexpansion and increased risk of pain and compression of the portal vein and cystic duct . The optimal technique of bilateral stent placement remains debated and is limited by the lack of randomized control studies.…”

Section: Malignant Hilar Obstructionmentioning

confidence: 99%

Endoscopic palliation of biliary obstruction

Aadam

Liu

2019

Journal of Surgical Oncology

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Advanced pancreaticobiliary malignancy tends to be uncurable at presentation and causes significant morbidity for patients. Palliation for malignant biliary obstruction should be minimally invasive, cost-effective, and aim to improve quality of life of patients. Strategies of endoscopic palliation of malignant biliary obstruction can differ based on sites and degree of biliary obstruction with complex decisions of optimal stent type and placement that involve conscientious planning by a multidisciplinary team. K E Y W O R D S biliary obstruction, distal, endoscopic, hilar, malignant, palliation J Surg Oncol. 2019;120:57-64. wileyonlinelibrary.com/journal/jso

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Endoscopic biliary stenting for unresectable malignant hilar obstruction

Cited by 32 publications

References 31 publications

Biliary stenting for hilar malignant biliary obstruction

Biliary stenting for hilar malignant biliary obstruction

Endoscopic palliation of biliary obstruction

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