Self-expandable metallic stents vs. plastic stents for endoscopic biliary drainage in hepatocellular carcinoma

Abstract

SEMSs were not superior to plastic stents for the palliation of malignant biliary obstruction in HCC with regard to successful drainage, stent patency, and adverse events. Patient survival was better in the plastic stent group. Given the lower cost, plastic stents could be a favorable option for malignant biliary obstruction caused by HCC.

Role of Endoscopic Biliary Drainage in Advanced Hepatocellular Carcinoma with Jaundice

“…Previous studies of the effects of biliary drainage in HCC patients with obstructive jaundice have shown that median survival was about 1.3-1.5 months in patients with ineffective drainage and about 4.9-8.7 months in patients with effective drainage [2,4,6,8]. Median survival was further prolonged, to about 8-13.4 months, in patients with effective drainage who received HCC treatment [14][15][16].…”

“…In addition, palliative biliary drainage would increase the possibility of these patients receiving additional treatment for HCC and prolong their survival [6]. Effective drainage is important in the management of HCC accompanied by obstructive jaundice [1][2][3][4][5][6][7][8]. In these studies, IHD dilatation was an indicator of obstruction in most patients.…”

“…Jaundice, which is associated with poor patient prognosis, is usually caused by diffuse tumor infiltration into the liver parenchyma, hilar invasion, and/or progressive terminal liver failure resulting from advanced underlying cirrhosis [1][2][3][4][5][6][7][8]. Obstructive jaundice, however, is uncommon, with only 0.5-13% of patients with HCC displaying definite obstructive jaundice.…”

“…Although several studies have assessed the effects of endoscopic or percutaneous palliation of obstructive jaundice in small numbers of patients with HCC [1][2][3][4][5][6][7][8], few reports have assessed the effectiveness and durability of direct endoscopic biliary drainage without nasobiliary drainage in HCC patients with obstructive jaundice. This study therefore evaluated whether endoscopic biliary drainage could improve survival and offer the chance of subsequent HCC treatment in patients with HCC and obstructive jaundice, even in the absence of evident signs of obstruction.…”

Triple Covered Metal Stent Deployment Using Side-by-Side Technique for Hemobilia due to Hepatocellular Carcinoma (with Video)

“…A hepatocellular carcinoma (HCC) rarely expands into the biliary tract; the incidence is 1.2 to 9.0% according to previous reports [1,2]. In this situation, because of its hypervascular nature, cholangitis or hemobilia may be sometimes complicated [3]. Hemobilia due to HCC can usually be treated by transarterial chemoembolization or radiofrequency treatment [4].…”