Irradiation stents vs. conventional metal stents for unresectable malignant biliary obstruction: A multicenter trial

Zhu, Hai-Dong; Guo, Jun; Huang, Ming; Ji, Jiansong; Xu, Hao; Lü, Jian; Li, Hailiang; Wang, Wenhui; Li, Yuliang; Chen, Ni; Shi, Haibin; Xiao, Enhua; Lv, Wei‐Fu; Sun, Jun‐Hui; Xu, Ke; Han, Guohong; Du, Lei; Ren, Wei; Li, Maoquan; Mao, Aiwu; Xiang, Hua; Zhang, Kaixian; Min, Jie; Zhu, Guangyu; Su, Chang; Chen, Li; Teng, Gao‐Jun

doi:10.1016/j.jhep.2017.12.028

Cited by 90 publications

(111 citation statements)

References 39 publications

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“…18 The first multicentre, randomized clinical trial, that included a total of 328 patients with Bismuth type I or II MBO who were enrolled from 20 Chinese centres, was conducted to further evaluate the effectiveness of radioactive stents in patients with unresectable hilar MBO. 29 The results showed that radioactive stent deployment could improve stent patency and overall survival compared with SEMS alone in patients with hilar MBO. 29 At present, there are three methods for deployment of 125 I seeds: (1) 125 I seeds strand inserted in a drainage catheter; 16 (2) an 125 I seeds-loaded stent; 18,29 and (3) an 125 I seeds strand fixed between SEMS and the bile duct wall.…”

Section: Discussionmentioning

confidence: 94%

“…29 The results showed that radioactive stent deployment could improve stent patency and overall survival compared with SEMS alone in patients with hilar MBO. 29 At present, there are three methods for deployment of 125 I seeds: (1) 125 I seeds strand inserted in a drainage catheter; 16 (2) an 125 I seeds-loaded stent; 18,29 and (3) an 125 I seeds strand fixed between SEMS and the bile duct wall. 17,28 The advantage of the first method is replaceability of the 125 I seeds strand, but a disadvantage is the limitation of external biliary drainage.…”

Section: Discussionmentioning

confidence: 94%

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Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction

Zhou

Huang

et al. 2019

J Int Med Res

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Objective: To assess the safety and effectiveness of a self-expandable metallic stent (SEMS) combined with Iodine-125 seeds strand to treat hilar malignant biliary obstruction (MBO). Methods: This retrospective study included patients who had received SEMS with 125 I seeds strand (seeds group) or SEMS alone (controls) to treat hilar MBO. Demographic, biochemical, stent patency, overall survival and complications data were extracted and analysed. Results: A total of 76 patients were included (seeds group, n ¼ 40; controls, n ¼ 36), with a total of 608 seeds deployed in the seeds group (mean, 15.2 AE 4.1 [range, 8-25] seeds per patient). Statistically significant between-group differences were shown in median stent patency time (seeds group, 387.0 AE 27.9 days [95% confidence interval {CI} 332.4, 441.6] versus controls, 121.0 AE 9.1 days [95% CI 103.2, 138.8]) and in median overall survival (seeds group, 177.0 AE 17.9 days [95% CI 141.8, 212.2] versus controls, 123.0 AE 20.4 [95% CI 83.0, 163.0]). There were no statistically significant between-group differences in complication rates. Conclusion: SEMS combined with 125 I seeds strand is safe, feasible, and tolerable in treating patients with hilar MBO, and may be effective in prolonging stent patency time and overall survival.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction

Zhou

Huang

et al. 2019

J Int Med Res

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“…Studies have found that I-125 is associated with significantly longer stent patency and mean survival time. 58,59 A 2019 retrospective study of patients with advanced extrahepatic cholangiocarcinoma and biliary obstruction stenting alone versus stenting plus I-125 particle implantation showed a significantly decreased risk of biliary re-obstruction in the I-125 group (19.5 vs. 35.2%, p < 0.05) without a significant difference in postoperative complications. 60 Drug-eluting stents are also being studied in MBO with the hypothesis that chemotherapy-eluting stents would slow down tumor ingrowth and decrease biofilm development resulting in increased stent patency.…”

Section: Novel Stents Under Studymentioning

confidence: 99%

Multidisciplinary Approach to Malignant Biliary Obstruction

Kim

Rahman

Tenney

et al. 2020

Digestive Disease Interventions

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Treatment of malignant biliary obstruction (MBO) requires the coordination of multiple specialties, including oncologists, surgeons, gastroenterologists, and interventional radiologists. If the tumor is resectable, surgical candidates can usually proceed to surgery without preoperative biliary drainage. For patients who undergo biliary drainage, endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC) combined with biliary stenting are techniques with comparable technical success and mortality, each with distinct advantages and risks. Advances in endoscopic ultrasound allow drainage in patients with challenging anatomy. There are a multitude of devices used for biliary decompression. Self-expanding metal stents (SEMS), with longer patency rates, are in most instances preferred over plastic stents for MBO, especially in patients with life expectancy more than 3 to 4 months. Advantages of covered SEMS versus uncovered SEMS remain controversial as covered stents can prevent tumor ingrowth but at the expense of potential increase in stent migrations. Extra-anatomic biliary drainage using lumen-apposing metal stents is an emerging technique which shows promise when conventional ERCP fails. It is imperative to understand these techniques when tailoring a treatment strategy. The goal of this article is to discuss a multidisciplinary approach for MBO to promote comprehensive care using case examples to highlight essential principles.

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“…Manuscript to be reviewed 1 Table 5. The cluster analysis of 8 clusters Cluster Number of MeSH terms a Cluster analysis 23,34,56,58,69,72,79,82 Stents placement in pancreatic neoplasms 5,9,10,19,21,24,27,36,39,40,41 The complications of stents placement in bile duct neoplasms and pancreatic neoplasms 8,35,45,49,50,52,54,71,73,74,75,76 postoperative complications after stent placement such as pancreaticoduodenectomy 1,2,3,6,11,15,17,18,46,47,51,60,67,80 Stents for the prevention of pancreatic fistula following pancreaticoduodenectomy 12,13,14,22,28,37,48,61,65 Prophylactic pancreatic duct stent can reduce the incidence of post-ERCP pancreatitis (PEP) 4,…”

Section: Figurementioning

confidence: 99%

“…It has been reported that percutaneous insertion of short metal stents supplies for a secure treatment, which is beneficial for patients in resectable pancreatic head cancer with jaundice [1]. With in-depth research, an irradiation pancreatic stent may provide longer patency and better patient survival [2]. And endoscopic application significantly improves the therapeutic effect of pancreatic stent [3].…”

Section: Introductionmentioning

confidence: 99%

Peer Review #3 of "Identification of research trends concerning application of stent implantation in the treatment of pancreatic diseases by quantitative and biclustering analysis: a bibliometric analysis (v0.1)"

2019

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In recent years, with the development of biological materials, the types and clinical applications of stents have been increasing in pancreatic diseases. However, relevant problems are also constantly emerging. Our purpose was to summarize current hotspots and explore potential topics in the fields of the application of stent implantation in the treatment of pancreatic diseases for future scientific research. Methods: Publications on the application of stents in pancreatic diseases were retrieved from PubMed without language limits. High-frequency Medical Subject Headings (MeSH) terms were identified through Bibliographic Item Co-Occurrence Matrix Builder (BICOMB). Biclustering analysis results were visualized utilizing the gCLUTO software. Finally, we plotted a strategic diagram. Results: 4087 relevant publications were obtained from PubMed until May 15 th , 2018. 83 high-frequency MeSH terms were identified. Biclustering analysis revealed that these high-frequency MeSH terms were classified into 8 clusters. After calculating the density and concentricity of each cluster, strategy diagram was presented. The cluster 5 "complications such as pancreatitis associated with stent implantation" was located at the fourth quadrant with high centricity and low density. Conclusions: In our study, we found 8 topics concerning the application of stent implantation in the treatment of pancreatic diseases. How to reduce the incidence of postoperative complications and improve the prognosis of patients with pancreatic diseases by stent implantation could become potential hotspots in the future research.

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Irradiation stents vs. conventional metal stents for unresectable malignant biliary obstruction: A multicenter trial

Cited by 90 publications

References 39 publications

Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction

Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction

Multidisciplinary Approach to Malignant Biliary Obstruction

Peer Review #3 of "Identification of research trends concerning application of stent implantation in the treatment of pancreatic diseases by quantitative and biclustering analysis: a bibliometric analysis (v0.1)"

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