Common bile duct obstruction due to malignancy: treatment with plastic versus metal stents.

Lämmer, Johannes; Hausegger, K. A.; Flückiger, F; Winkelbauer, F.; Wildling, R; Klein, G; Thurnher, Siegfried; Havelec, L

doi:10.1148/radiology.201.1.8816539

Cited by 239 publications

(139 citation statements)

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“…The complication rates appear to be similar to those in previous studies using either plastic stents or metallic expandable stents (22,23). These complications may have resulted from transhepatic drainage instead of the stent itself.…”

Section: Discussionsupporting

confidence: 82%

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New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

Woo

Kim

Lee

et al. 2012

Korean J Transplant

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Background: In cases of endoscopic intervention treatment for biliary stricture which fail, a percutaneous approach can be subsequently attempted. However, the quality of life is lower for those patients with percutaneous transhepatic biliary drainage (PTBD) tubes than those with endoscopic retrograde biliary drainage tubes. In this study, we report the outcome of the application of percutaneous transhepatic biliary stenting (PTBS) for use in subsequent endoscopic treatment of biliary stricture after living donor liver transplantation (LDLT).Methods: Of 165 patients who underwent LDLT, 40 (24.2%) were diagnosed with anastomotic biliary strictures. Of these patients, seven agreed to treatment using PTBS using a plastic stent with endoscopic follow-up instead of treatment by insertion of a PTBD tube, and were enrolled in this study.Results: In all seven patients, the use of this technique enabled effective advancement of a guide wire and successful placement of one or two plastic stents (7 or 10 Fr) into the PTBD tract. There were no PTBS-related complications associated with the procedure. The median duration for stent use was 40.3 weeks (range; 27.6~65.0). Upon final removal of all stents, the stricture had been resolved in four (57%) of the seven patients.Conclusions: Our study data suggested that, after failed use of ERCP in the treatment of biliary stricture after LDLT, the use of PTBS and ERCP may be an effective and safe treatment.

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Section: Discussionsupporting

confidence: 82%

“…In plastic stent insertion by the percutaneous approach, large-bore devices with a diameter of 10∼14 Fr can be used (22). Insertion of large prostheses, however, increases the trauma to the patient, particularly during transhepatic procedures.…”

Section: Discussionmentioning

confidence: 99%

New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

Woo

Kim

Lee

et al. 2012

Korean J Transplant

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“…A plastic stent may also be used according to the preference of each facility with available equipment and techniques. (Grade 2, evidence level C) Statement: For the palliative treatment of distal bile duct obstruction, several randomized trials comparing plastic stent (PS) and uncovered SEMS showed that uncovered SEMS has significantly longer term patency than PS [100][101][102]. These trials also showed the lower complication rate of SEMS than PS.…”

Section: Cq15: Which Type Of Biliary Stent Is Appropriate For Unresecmentioning

confidence: 99%

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Miyazaki

Yoshitomi

Miyakawa³

et al. 2015

J Hepato Biliary Pancreat

237

165

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Background The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract and ampullary carcinomas in 2008. Novel treatment modalities and handling of clinical issues have been proposed after the publication. New approaches for editing clinical guidelines, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, also have been introduced for better and clearer grading of recommendations. Methods Clinical questions (CQs) were proposed in seven topics. Recommendation, grade of recommendation and statement for each CQ were discussed and finalized by evidencebased approach. Recommendation was graded to grade 1 (strong) and 2 (weak) according to the concept of GRADE system. Results The 29 CQs covered seven topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, (6) radiation therapy, and (7) pathology. In 27 CQs, 19 recommendations were rated strong and 11 recommendations weak. Each CQ included the statement of how the recommendation was graded. Conclusions This guideline provides recommendation for important clinical aspects based on evidence. Future collaboration with cancer registry will be a key for assessment of the guidelines and establishment of new evidence. Free full-text articles and a mobile application of this guideline are available via

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“…The most frequent localization for the infiltrating type of cholangiocarcinoma is proximal or middle bile duct, where the use of percutaneous approach of prothesis implantation is preferable compared to endoscopic route. According to our experience and to published studies, 3,4 the patency of metal stents lasts longer in comparison with plastic drains. Moreover, tolerance and patient compliance are higher when using a metallic stent.…”

Section: Introductionmentioning

confidence: 66%

“…Median time from the first percutaneous intervention to the successful implantation of metal stent was 44 days, and the average number of percutaneous sessions totalled 5.2 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). This depended on the favorable effect of percutaneous drainage (for at least 2 weeks, with substantial improvement of laboratory tests), of the technique and the necessary time for histological confirmation of malignant stenosis.…”

Section: Resultsmentioning

confidence: 99%

Multimodal Oncological Therapy Comprising Stents, Brachytherapy, and Regional Chemotherapy for Cholangiocarcinoma

Andrašina¹,

Válek²,

Pánek³

et al. 2010

Gut Liver

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Background/Aims: To prospectively evaluate our palliative management of unresectable cholangiocarcinoma (CC) treated with tailored multimodal oncological therapy. Methods: Between January 2005 and January 2010, 50 consecutive patients with unresectable CC and jaundice were palliated with percutaneous drainage. Forty-three patients underwent metallic-stent implantation followed by brachytherapy. Patients were divided into two arms: the intra-arterial chemotherapy arm (IA arm, n=17) consisted of patients treated with locoregional treatment (IA admission of Cisplatin and 5-fluorouracil, or chemoembolization with Lipiodol) and/or systemic chemotherapy, while the systemic chemotherapy arm (IV arm, n=23) included all the other patients, who were treated only with systemic chemotherapy. Results: In total, 78 metal self-expandable stents were placed. Hilar involvement with mass-forming and periductal infiltrating types of CC (84%) was predominant. The average number of percutaneous interventional procedures was 11.61 per patient (range, 4-35). The median overall survival from diagnosis of disease for all patients was 13.5 months (range, 11.0-18.8 months). The median overall survival times were 25.2 months (range, 15.2-31.3 months) and 11.5 months (range, 8.5-12.6 months) in the IA and IV arms, respectively (p＜0.05). The 1-, 2-, and 3-year survival rates in the IA and IV arms were 88.2%, 52.9%, and 10.1% and 43.5%, 25.4, and 0%, respectively. There were no major complications (WHO III/IV) due to interventional procedures. Conclusions: We could reach acceptable prognosis in patients with unresectable CC using complex tailored oncological therapy. However, the main limitations of prolonging survival are performance status, patient compliance and the maintaining of biliary tract patency. (Gut Liver 2010;4(Suppl. 1):S82-88)

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Common bile duct obstruction due to malignancy: treatment with plastic versus metal stents.

Abstract: Use of self-expanding metal stents appears to show substantial benefits for patients and to be cost-effective.

Cited by 239 publications

References 0 publications

New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Multimodal Oncological Therapy Comprising Stents, Brachytherapy, and Regional Chemotherapy for Cholangiocarcinoma

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Common bile duct obstruction due to malignancy: treatment with plastic versus metal stents.

Abstract: Use of self-expanding metal stents appears to show substantial benefits for patients and to be cost-effective.

Cited by 239 publications

References 0 publications

New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

Multimodal Oncological Therapy Comprising Stents, Brachytherapy, and Regional Chemotherapy for Cholangiocarcinoma

Contact Info

Product

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Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition