Dong Ki Lee1. 1. Department of Internal Medicine, Kangnam Hospital, Yonsei University, P.O. Box 1217, Kangnam, Seoul, Korea. dklee@yuhs.ac
Abstract
INTRODUCTION: In unresectable malignant bile duct obstruction, endoscopic stent insertion is the treatment of choice. However, the current stent allows only mechanical palliation of the obstruction, and has no anti-tumor effect. Currently, in the vascular field, the drug-eluting stent (DES) is very highly favored. MATERIAL AND METHODS: The requirements for a DES in a non-vascular tract, such as the bile duct, are far different from those of a DES to be used in the vascular tract. The non-vascular DES must suppress tumor proliferation as well as mucosal hyperplasia. For example, the non-vascular stent might be covered with a membrane that gradually releases a chemo-agent. We do not have much experience with DES in the bile duct. Nonetheless, we are continuously testing many anti-tumor agents in animal and human studies. CONCLUSION: We expect and hope DES will work effectively for tumor cells in diverse ways and, more importantly, will prolong stent patency and the patients' survival periods. But considerable investigation and a clinical study of DES will be required to achieve these goals.
INTRODUCTION: In unresectable malignant bile duct obstruction, endoscopic stent insertion is the treatment of choice. However, the current stent allows only mechanical palliation of the obstruction, and has no anti-tumor effect. Currently, in the vascular field, the drug-eluting stent (DES) is very highly favored. MATERIAL AND METHODS: The requirements for a DES in a non-vascular tract, such as the bile duct, are far different from those of a DES to be used in the vascular tract. The non-vascular DES must suppress tumor proliferation as well as mucosal hyperplasia. For example, the non-vascular stent might be covered with a membrane that gradually releases a chemo-agent. We do not have much experience with DES in the bile duct. Nonetheless, we are continuously testing many anti-tumor agents in animal and human studies. CONCLUSION: We expect and hope DES will work effectively for tumor cells in diverse ways and, more importantly, will prolong stent patency and the patients' survival periods. But considerable investigation and a clinical study of DES will be required to achieve these goals.
Authors: David H Ballard; Karthik Tappa; Christen J Boyer; Udayabhanu Jammalamadaka; Kavya Hemmanur; Jeffery A Weisman; Jonathan S Alexander; David K Mills; Pamela K Woodard Journal: J 3D Print Med Date: 2019-05-31
Authors: Sung Ill Jang; Se Joon Lee; Seok Jeong; Don Haeng Lee; Myung-Hwan Kim; Hong Jin Yoon; Dong Ki Lee Journal: Gut Liver Date: 2017-07-15 Impact factor: 4.519