Takeshi Ogura1,2, Mamoru Takenaka1,3, Hideyuki Shiomi1,4, Nobu Nishioka1,2, Saori Ueno1,2, Akira Miyano1,2, Rieko Kamiyama1,2, Kazuhide Higuchi1,2. 1. TSOZ Pancreatobiliary Study Group, Osaka, Japan. 2. 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan. 3. Departments of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan. 4. Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Abstract
BACKGROUND: Malignant hilar biliary obstruction (MHBO) can be treated with bilateral self-expandable metal stents (SEMS) deployed using side-by-side (SBS) or stent-in-stent (SIS) techniques. Moving cell stents (MCS) are a novel type of SEMS. The present study evaluated the technical feasibility of treating MHBO using bilateral novel uncovered SEMS to insert an SIS technique without dilating the mesh of a first stent within a single session. METHOD: We retrospectively assessed patients who were complicated with obstructive jaundice due to MHBO between August and December 2018. Technical success was defined as the deployment of a bilateral MCS into two or more biliary tracts using SIS technique without a dilation device. RESULTS: The present study analyzed data from 23 consecutive patients who were complicated with MHBO. Bilateral SIS technique with MCS was deployed in 22 (95.6%) of the 23 patients without dilating the mesh of the first stent. Multiple guidewire insertion failed in one patient with Bismuth-type IV. The median procedural duration was 33.6 min. Time to recurrent biliary obstruction was 230 days. Severe adverse events were not seen in any patients. CONCLUSION: In conclusion, uncovered moving cell SEMS might facilitate bilateral stent deployment using SIS technique.
BACKGROUND: Malignant hilar biliary obstruction (MHBO) can be treated with bilateral self-expandable metal stents (SEMS) deployed using side-by-side (SBS) or stent-in-stent (SIS) techniques. Moving cell stents (MCS) are a novel type of SEMS. The present study evaluated the technical feasibility of treating MHBO using bilateral novel uncovered SEMS to insert an SIS technique without dilating the mesh of a first stent within a single session. METHOD: We retrospectively assessed patients who were complicated with obstructive jaundice due to MHBO between August and December 2018. Technical success was defined as the deployment of a bilateral MCS into two or more biliary tracts using SIS technique without a dilation device. RESULTS: The present study analyzed data from 23 consecutive patients who were complicated with MHBO. Bilateral SIS technique with MCS was deployed in 22 (95.6%) of the 23 patients without dilating the mesh of the first stent. Multiple guidewire insertion failed in one patient with Bismuth-type IV. The median procedural duration was 33.6 min. Time to recurrent biliary obstruction was 230 days. Severe adverse events were not seen in any patients. CONCLUSION: In conclusion, uncovered moving cell SEMS might facilitate bilateral stent deployment using SIS technique.
Authors: Gabriel Mayo Vieira de Souza; Igor Braga Ribeiro; Mateus Pereira Funari; Diogo Turiani Hourneaux de Moura; Maria Vitória Cury Vieira Scatimburgo; João Remí de Freitas Júnior; Sergio A Sánchez-Luna; Renato Baracat; Eduardo Turiani Hourneaux de Moura; Wanderley Marques Bernardo; Eduardo Guimarães Hourneaux de Moura Journal: World J Hepatol Date: 2021-05-27