Efficacy of Endoscopic Over 3-branched Partial Stent-in-Stent Drainage Using Self-expandable Metallic Stents in Patients With Unresectable Hilar Biliary Carcinoma

Uchida, Daisuke; Kato, Hironari; Muro, Shinichiro; Noma, Yasuhiro; Yamamoto, Naoki; Horiguchi, Shigeru; Harada, Ryo; Tsutsumi, Keisuke; Kawamoto, Hirofumi; Yamamoto, Kazuhide

doi:10.1097/mcg.0000000000000213

Cited by 17 publications

(15 citation statements)

References 17 publications

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“…Inoue et al ( 35 ) reported the insertion of three SEMSs, where the combination of the placement of stent-in-stent SEMSs and side-by-side SEMSs was performed. In a report written by Uchida et al ( 20 ), more than three-branched drainage improved the duration of patency in patients with unresectable hilar biliary carcinoma. In that report, six patients received four SEMSs using 7- or 8-Fr devices.…”

Section: Discussionmentioning

confidence: 96%

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Hilar Malignant Biliary Obstruction Treated with Four Metallic Stents Involving a New Slim Device

et al. 2021

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Endoscopic hilar multiple stenting is challenging. A 68-year-old patient had self-expandable metallic stents (SEMSs) inserted for unresectable hilar malignant biliary obstruction. After the SEMSs were inserted into the left hepatic duct and bile duct branch of segment (B) 6, a new SEMS with a wide mesh and slim delivery system was inserted into the right anterior hepatic duct. However, liver abscess and dilated B7 were observed on computed tomography; therefore, an additional new SEMS was quickly and easily inserted into B7. After the placement of these four SEMSs, the liver abscess improved. The new SEMS was effective for hilar multiple biliary drainage.

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Section: Discussionmentioning

confidence: 96%

“…We experienced a case in which four uncovered SEMSs were inserted to treat liver abscess. In a retrospective study, six patients with hilar biliary obstruction in whom four uncovered SEMSs were placed were reported ( 20 ). However, the details concerning the insertion of the four uncovered SEMSs were not described.…”

Section: Introductionmentioning

confidence: 99%

Hilar Malignant Biliary Obstruction Treated with Four Metallic Stents Involving a New Slim Device

et al. 2021

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“…reported a pioneering study on the placement of three or more SEMS in 2007, where they demonstrated nine successful cases of placement by the SIS method. In 2015, Uchida et al . reported a retrospective study comparing placement of three or more SEMS with placement of two or less.…”

Section: Discussionmentioning

confidence: 99%

“…Kawamoto et al 9 reported a pioneering study on the placement of three or more SEMS in 2007, where they demonstrated nine successful cases of placement by the SIS method. In 2015, Uchida et al 20 reported a retrospective study comparing placement of three or more SEMS with placement of two or less. They found that the patency period and survival in the three or more stents group was significantly longer than that in the two or fewer stents group among the patients achieving disease control.…”

Section: Discussionmentioning

confidence: 99%

Combined side‐by‐side and stent‐in‐stent method for triple metal stenting in patients with malignant hilar biliary obstruction

Inoue

Ibusuki

Kitano

et al. 2019

Digestive Endoscopy

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Background and Aim Endoscopic placement of three branched self‐expandable metallic stents (SEMS) for high‐grade malignant hilar biliary obstruction (MHBO) is technically challenging. We examined the feasibility and efficacy of a novel stenting method combining side‐by‐side and stent‐in‐stent (SBSIS) placement for MHBO. Methods Between January 2015 and December 2018, 27 consecutive patients with high‐grade MHBO underwent SBSIS placement. We evaluated the technical success, functional success, recurrent biliary obstruction (RBO), adverse events other than RBO, and reintervention success rates associated with SBSIS placement. Results Technical success rate was 85% (23/27). Insertion of the third SEMS failed in four patients, and median diameter of the common bile duct (CBD) was significantly smaller in patients in whom technical failure occurred (5 mm vs 8 mm; P = 0.004). Functional success was achieved in all patients in whom the procedure was a technical success. Rate of adverse events other than RBO was 15% (4/27). RBO rate was 43% (10/23), and median time to RBO was 157 days. Success rate of endoscopic reintervention for RBO was 89% (8/9). Conclusion SBSIS placement showed favorable results and is a promising option in patients with high‐grade MHBO requiring triple metal stenting. However, it might be preferable to avoid SBSIS in patients with a narrow CBD. Clinical Trial Registry: UMIN000035721

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“…Placement of multiple metal stents (MS) for the management of high‐grade malignant hilar biliary obstruction (MHBO) is useful, and biliary radiofrequency ablation (RFA) has been suggested to improve stent patency . However, to our knowledge, there are no reports of RFA procedures carried out using a single‐balloon endoscope (SBE) in patients with surgically altered anatomy.…”

Section: Brief Explanationmentioning

confidence: 99%

Radiofrequency ablation combined with multiple biliary metal stent placement using short‐type single‐balloon endoscope in patients with surgically altered anatomy

Inoue

Ito

Yoneda

2018

Digestive Endoscopy

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Efficacy of Endoscopic Over 3-branched Partial Stent-in-Stent Drainage Using Self-expandable Metallic Stents in Patients With Unresectable Hilar Biliary Carcinoma

Abstract: The use of endoscopic over 3-branched biliary drainage with a SEMS may improve the duration of patency in patients with HBS.

Cited by 17 publications

References 17 publications

Hilar Malignant Biliary Obstruction Treated with Four Metallic Stents Involving a New Slim Device

Hilar Malignant Biliary Obstruction Treated with Four Metallic Stents Involving a New Slim Device

Combined side‐by‐side and stent‐in‐stent method for triple metal stenting in patients with malignant hilar biliary obstruction

Radiofrequency ablation combined with multiple biliary metal stent placement using short‐type single‐balloon endoscope in patients with surgically altered anatomy

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