Hepatobiliary Pancreat Dis Int. 2018;17(5):437-442.
Revision of bilateral self-expandable metallic stents placed using the stent-in-stent technique for malignant hilar biliary obstruction.
제1저자 손준혁,이희승 · 교신저자 이상협
소속 (5)
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. Electronic address: gidoctor@snuh.org.
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea; Department of Gastroenterology and Hepatology, SMG-SNU Boramae Medical Center, Seoul, Korea.
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Abstract
BACKGROUND Endoscopic biliary decompression using bilateral self-expandable metallic stent (SEMS) placed using the stent-in-stent (SIS) technique is considered favorable for unresectable malignant hilar biliary obstruction (MHBO). However, occlusion of the bilateral SIS placement is frequent and revision can be challenging. This study was performed to investigate the efficacy, the long-term patency and the appropriate approach for revision of occluded bilateral SIS placement in unresectable MHBO.
METHODS From January 2011 to July 2016, thirty-eight patients with unresectable MHBO underwent revision of occluded bilateral SIS placement. Clinical data including success rates and patency of revision, were retrospectively analyzed.
RESULTS The technical success rate of revision was 76.3%. The clinical success rate of revision was 51.7% and mean patency of revision was 49.1 days. No significant predictive factor for clinical failure of revision was observed. The cell size of SEMS was not found to have significant effects on clinical success rates or revision patency.
CONCLUSIONS Revision of occluded bilateral SIS placement for MHBO showed fair patency and clinical success rate. Revision method and cell size of SEMS were not found to influence clinical outcomes.
Copyright © 2018 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.
Keywords
Malignant hilar biliary obstructionRevisionSelf-expandable metallic stentStent-in-stent
그 밖의 정보
- 출판 형태
- Journal Article
- 저널
- Hepatobiliary & pancreatic diseases international : HBPD INT · ISSN 1499-3872
- 전자 출판
- 2018-07-26
- MeSH
- Aged · Aged, 80 and over · Bile Duct Neoplasms / complications / mortality / pathology · Chi-Square Distribution · Cholestasis / etiology / mortality / pathology / surgery · Cohort Studies · Endoscopy / adverse effects / methods · Female · Humans · Kaplan-Meier Estimate · Male · Middle Aged · Prognosis · Recurrence · Reoperation / methods · Retrospective Studies · Risk Assessment · Self Expandable Metallic Stents / adverse effects · Survival Rate · Treatment Outcome