Comparison of the Clinical Outcomes of Suprapapillary and Transpapillary Stent Insertion in Unresectable Cholangiocarcinoma with Biliary Obstruction

Shin, Jongbeom; Park, Jin-Seok; Jeong, Seok; Lee, Don Haeng

doi:10.1007/s10620-019-05859-1

Cited by 16 publications

(28 citation statements)

References 20 publications

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“…57 Thus, the next step is to prospectively compare bilateral (SBS) MS placement across the SO with that above the SO in a RCT, which has not been performed thus far in the field of EBS for MHBO (Table 2). 43,45,[58][59][60][61][62][63] Three, all retrospective, comparative studies on EBS with MSs alone reported negative results, except for the study by Okamoto et al with the mixture of endoscopic and percutaneous placement (Table 2). [60][61][62] Cosgrove et al 60 performed a retrospective comparison of bilateral SBS deployment of self-expandable MSs (SEMSs) above and across the SO in the management of unresectable MHBO and showed that bilateral SBS SEMS placement above and across the SO resulted in similar success rates and stent patency durations.…”

Section: Endoscopic Transpapillary Biliary Stenting For Hilar Biliary Obstructionmentioning

confidence: 99%

“…43,45,[58][59][60][61][62][63] Three, all retrospective, comparative studies on EBS with MSs alone reported negative results, except for the study by Okamoto et al with the mixture of endoscopic and percutaneous placement (Table 2). [60][61][62] Cosgrove et al 60 performed a retrospective comparison of bilateral SBS deployment of self-expandable MSs (SEMSs) above and across the SO in the management of unresectable MHBO and showed that bilateral SBS SEMS placement above and across the SO resulted in similar success rates and stent patency durations. However, considerably fewer complications, with a trend toward lower rates of pancreatitis, were observed for SEMS placement above the SO.…”

Section: Endoscopic Transpapillary Biliary Stenting For Hilar Biliary Obstructionmentioning

confidence: 99%

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Possible reasons for the regrettable results of patency of an inside stent in endoscopic transpapillary biliary stenting

Kuwatani

Kawakubo

Sakamoto

2021

Digestive Endoscopy

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Endoscopic biliary decompression is a minimally invasive procedure for cholestasis since the first endoscopic retrograde cholangiopancreatography-guided biliary stenting performed by Soehendra and Reynders-Frederix. Among the endoscopic biliary decompression, endoscopic transpapillary biliary stenting (EBS), is a mainstream choice and presently has two methods of placement: stenting above the sphincter of Oddi (SO) (suprapapillary) and stenting across the SO (transpapillary). Stent patency is the most important concern for patients, endoscopists and physicians because it can affect both the life prognosis and treatment schedule of patients. Biliary stent occlusion can occur because of several factors. Among them, direct food impaction, biofilm formation, and sludge formation play important roles and are presumed to be theoretically overcome by EBS above the SO. Thus, EBS above the SO is expected to result in a longer patency than EBS across the SO.In the literature, there have been six comparative studies on EBS for distal biliary obstruction in which the stent was placed above or across the SO, including two randomized controlled trials (RCTs) with negative results of stenting above the SO. With respect to EBS for hilar biliary obstruction, there have been no RCTs, whereas four retrospective comparative studies with negative results and four retrospective comparative studies showing positive results of stenting above the SO have been reported. In this review, we focused on EBS above and across the SO, and summarized the positive and negative results of the two types of stenting to promote effective clinical practice and to provide a basis for future studies.

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Section: Endoscopic Transpapillary Biliary Stenting For Hilar Biliary Obstructionmentioning

confidence: 99%

Section: Endoscopic Transpapillary Biliary Stenting For Hilar Biliary Obstructionmentioning

confidence: 99%

Possible reasons for the regrettable results of patency of an inside stent in endoscopic transpapillary biliary stenting

Kuwatani

Kawakubo

Sakamoto

2021

Digestive Endoscopy

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“…Notably, post-procedure pancreatitis was observed in seven patients, exclusively in the SBS group. A possible explanation could be that the SBS stents placed across the papilla may exert higher pressure on the pancreatic duct orifice; albeit a prior study by Shin et al did not find a higher complication rate with transpapillary placement in comparison with supra-papillary placement [9]. Another potential explanation offered by the authors is the higher number of trainees involved with SBS stenting as compared to SIS.…”

mentioning

confidence: 82%

Endoscopic Stenting for Malignant Hilar Biliary Obstruction: After You Double Down, Are You In or Out?

2020

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“…A potential disadvantage of suprapapillary stent placement to consider, however, is that it can make endoscopy for future stent revision more challenging. 32,33 In patients with Bismuth II, III, or IV obstruction, drainage of more than one isolated ductal segment may be needed, particularly when the indication is to lower bilirubin for chemotherapy. 14,27 Parallel stents in "Y" or "T" configuration may be placed simultaneously, or if done in sequential procedures stent may be placed through the interstices of an indwelling stent (►Fig.…”

Section: Techniquementioning

confidence: 99%

Treatment of Malignant Bile Duct Obstruction: What the Interventional Radiologist Needs to Know

Camacho

Brody

Covey

2021

Semin intervent Radiol

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Management of malignant bile duct obstruction is both a clinically important and technically challenging aspect of caring for patients with advanced malignancy. Bile duct obstruction can be caused by extrinsic compression, intrinsic tumor/stone/debris, or by biliary ischemia, inflammation, and sclerosis. Common indications for biliary intervention include lowering the serum bilirubin level for chemotherapy, ameliorating pruritus, treating cholangitis or bile leak, and providing access for bile duct biopsy or other adjuvant therapies. In some institutions, biliary drainage may also be considered prior to hepatic or pancreatic resection. Prior to undertaking biliary intervention, it is essential to have high-quality cross-sectional imaging to determine the level of obstruction, the presence of filling defects or atrophy, and status of the portal vein. High bile duct obstruction, which we consider to be obstruction above, at, or just below the confluence (Bismuth classifications IV, III, II, and some I), is optimally managed percutaneously rather than endoscopically because interventional radiologists can target specific ducts for drainage and can typically avoid introducing enteric contents into isolated undrained bile ducts. Options for biliary drainage include external or internal/external catheters and stents. In the setting of high obstruction, placement of a catheter or stent above the ampulla, preserving the function of the sphincter of Oddi, may lower the risk of future cholangitis by preventing enteric contamination of the biliary tree. Placement of a primary suprapapillary stent without a catheter, when possible, is the procedure most likely to keep the biliary tree sterile.

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Comparison of the Clinical Outcomes of Suprapapillary and Transpapillary Stent Insertion in Unresectable Cholangiocarcinoma with Biliary Obstruction

Cited by 16 publications

References 20 publications

Possible reasons for the regrettable results of patency of an inside stent in endoscopic transpapillary biliary stenting

Possible reasons for the regrettable results of patency of an inside stent in endoscopic transpapillary biliary stenting

Endoscopic Stenting for Malignant Hilar Biliary Obstruction: After You Double Down, Are You In or Out?

Treatment of Malignant Bile Duct Obstruction: What the Interventional Radiologist Needs to Know

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