Evaluation of a newly modified nonflared fully covered metal stent, 12 mm in diameter, for intraductal placement in patients with malignant biliary strictures: a feasibility study
- Abstract
- BACKGROUND AND STUDY AIM: The nonflared ends of fully covered, self-expandable, metal stents (FCSEMSs) may minimize stent-induced ductal injury. Suprapapillary intraductal placement of nonflared FCSEMSs for malignant biliary stricture might reduce duodenobiliary reflux and pancreatitis. The aim of this study was to evaluate the efficacy of a newly modified, nonflared FCSEMS for intraductal placement in patients with malignant biliary stricture. PATIENTS AND METHODS: A total of 51 patients with nonhilar, extrahepatic, malignant biliary stricture were enrolled prospectively. The nonflared FCSEMS is 12 mm in diameter, and has a central saddle and a distal lasso of 7 cm in length. An FCSEMS was placed above the papilla in all patients, with the central saddle positioned at the stricture to prevent stent migration. RESULTS: The technical and clinical success rates were 100 % and 98 %, respectively. Early adverse events occurred in one patient (2.0 %; mild pancreatitis). A total of 12 patients underwent surgery with curative intent, one of whom (8.3 %) experienced a postoperative adverse event. No stent migration occurred in any of the patients. Cholecystitis developed in one patient (2.0 %) as a late adverse event. Stent occlusion occurred in 44.7 % (17/38), and endoscopic removal of the stent was successful in 87.5 % of patients. The mean stent patency was 297 days (95 % confidence interval, 211 - 383). CONCLUSIONS: Intraductal placement of the nonflared FCSEMS, 12 mm in diameter, was feasible for the palliative and preoperative management of patients with malignant biliary stricture. Long-term follow-up and prospective comparative studies are needed to evaluate the usefulness of intraductal placement of this stent.
- All Author(s)
- H. J. Choi
; J. H. Moon
; Y. N. Lee
; H. S. Kim
; M. H. Choi
; T. H. Lee
; S. W. Cha
; Y. D. Cho
; S. H. Park
; S. J. Kim
- Issued Date
- 2016
- Type
- Article
- Keyword
- Aged; Bile Ducts, Extrahepatic; Cholecystitis/etiology; Cholestasis/etiology/*therapy; Digestive System Neoplasms/*complications; Equipment Design; Feasibility Studies; Female; Humans; Male; Middle Aged; Pancreatitis/etiology; Prospective Studies; Prosthesis Implantation; *Self Expandable Metallic Stents/adverse effects
- ISSN
- 0013-726x
- Citation Title
- Endoscopy
- Citation Volume
- 48
- Citation Number
- 7
- Citation Start Page
- 625
- Citation End Page
- 631
- Language(ISO)
- eng
- DOI
- 10.1055/s-0042-105643
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2344
- 공개 및 라이선스
-
- 파일 목록
-
Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.