Estimation of the stent placement above the intact sphincter of Oddi against malignant bile duct obstruction

Uchida, Naoshige; Tsutsui, Kunihiko; Ezaki, Toru; Fukuma, Hiroki; Kamata, Hideki; Kobara, Hideki; Matsuoka, Hiroshi; Kinekawa, Fumihiko; Aritomo, Yuichi; Yokoyama, Fumi; Kita, Yuko; Masaki, Tsutomu; Ogawa, Masahiro; Nakatsu, Toshiaki; Watanabe, Seishiro; Kuriyama, Shigeki

doi:10.1007/s00535-004-1535-2

Cited by 41 publications

(52 citation statements)

References 17 publications

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“…However, the migration rate of stents placed above the sphincter of Oddi was 58% in their study. On the other hand, Uchida et al reported that the median patency duration of stents placed above the sphincter of Oddi was superior to that of stents placed across the sphincter of Oddi (255 vs. 82 days), and the respective occlusion rates were 37.5% and 93.8% [15]. Although their results with respect to stent patency were satisfactory, endoscopic sphincterotomy was required for stent exchange in most cases of stent occlusion.…”

Section: Discussionmentioning

confidence: 99%

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Threaded biliary inside stents are a safe and effective therapeutic option in cases of malignant hilar obstruction

et al. 2013

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BackgroundAlthough endoscopic biliary stents have been accepted as part of palliative therapy for cases of malignant hilar obstruction, the optimal endoscopic management regime remains controversial. In this study, we evaluated the safety and efficacy of placing a threaded stent above the sphincter of Oddi (threaded inside plastic stents, threaded PS) and compared the results with those of other stent types.MethodsPatients with malignant hilar obstruction, including those requiring biliary drainage for stent occlusion, were selected. Patients received either one of the following endoscopic indwelling stents: threaded PS, conventional plastic stents (conventional PS), or metallic stents (MS). Duration of stent patency and the incident of complication were compared in these patients.ResultsForty-two patients underwent placement of endoscopic indwelling stents (threaded PS = 12, conventional PS = 17, MS = 13). The median duration of threaded PS patency was significantly longer than that of conventional PS patency (142 vs. 32 days; P = 0.04, logrank test). The median duration of threaded PS and MS patency was not significantly different (142 vs. 150 days, P = 0.83). Stent migration did not occur in any group. Among patients who underwent threaded PS placement as a salvage therapy after MS obstruction due to tumor ingrowth, the median duration of MS patency was significantly shorter than that of threaded PS patency (123 vs. 240 days).ConclusionsThreaded PS are safe and effective in cases of malignant hilar obstruction; moreover, it is a suitable therapeutic option not only for initial drainage but also for salvage therapy.

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Section: Discussionmentioning

confidence: 99%

“…Placement of PS above the sphincter of Oddi (inside stents) was reportedly superior to conventional PS with respect to stent patency in cases of malignant bile duct obstruction [15]. However, another study showed that placement of the inside stent was associated with high rates of stent migration and occlusion [16].…”

Section: Introductionmentioning

confidence: 99%

Threaded biliary inside stents are a safe and effective therapeutic option in cases of malignant hilar obstruction

et al. 2013

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“…A retrospective study by Uchida et al. evaluated intraductal PS placement for the treatment of malignant common bile duct obstruction and found that PS placed inside bile ducts remained patent significantly longer than when the PS was placed across the sphincter of Oddi .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of plastic stent placement inside bile ducts for the treatment of unresectable malignant hilar obstruction (with videos)

Kaneko

Sugimori

Shimizu

et al. 2013

J Hepatobiliary Pancreat Sci

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“…Since disruption of the sphincter of Oddi (by passage of a stent across it) allows the ascension of micro-organisms (with subsequent colonization of the endoprosthesis), it may be feasible to reduce bacterial colonization by positioning stents above the sphincter, thus allowing it to function normally. There are clinical data that suggest that stents positioned in this manner have longer patency rates and lower failure rates; however, the numbers of patients in this study were very small (n = 16) [53].…”

Section: Plastic Stentsmentioning

confidence: 94%

Palliation of Malignant Obstructive Jaundice

et al. 2008

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Peri-ampullary and hepatic malignancies will frequently present with obstructive jaundice. For unresectable tumors, effective and lasting decompression of the biliary tree is essential to improve quality of life and survival. An overview of present treatment modalities for palliation of obstructive jaundice is provided, including a systematic review of the English literature regarding the optimum choice of palliation.

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Estimation of the stent placement above the intact sphincter of Oddi against malignant bile duct obstruction

Abstract: Placement of the stent above the intact sphincter of Oddi was associated with longer stent patency and lower occlusion rate.

Cited by 41 publications

References 17 publications

Threaded biliary inside stents are a safe and effective therapeutic option in cases of malignant hilar obstruction

Threaded biliary inside stents are a safe and effective therapeutic option in cases of malignant hilar obstruction

Efficacy of plastic stent placement inside bile ducts for the treatment of unresectable malignant hilar obstruction (with videos)

Palliation of Malignant Obstructive Jaundice

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