Expandable biliary metal stents for malignancies: endoscopic insertion and diathermic cleaning for tumor ingrowth

Cremer, Michel; Devière, Jacques; Sugai, Beatriz; Baize, Michel

doi:10.1016/s0016-5107(90)71113-3

Cited by 84 publications

(22 citation statements)

References 15 publications

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“…Diathermic cleaning of tumor ingrowth into the biliary tract through a metallic stent has been described, 8 but this was quite different from our treatment. For patients with advanced esophageal cancer, nothing causes more hardship than the inability to ingest food.…”

Section: Discussionmentioning

confidence: 55%

A New Method of Thermo-chemotherapy Using a Stent for Patients with Esophageal Cancer

et al. 2005

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Section: Discussionmentioning

confidence: 55%

A New Method of Thermo-chemotherapy Using a Stent for Patients with Esophageal Cancer

et al. 2005

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“…in Richtung auf primä r palliative Maßnahmen, wie z. B. die endoskopische Einlage von Metallstents [10,26] oder auch percutane Drainageverfahren, gelenkt werden. Ob eine systematische Lymphadenektomie im Falle einer Resektion die Prognose gü nstig beeinflußt, ist zum jetzigen Zeitpunkt nicht sicher zu beantworten [25,35].…”

Section: Diskussionunclassified

“…einer signifikanten Wirksamkeit adjuvanter Therapien [37], wä hrend der postoperativen (z. T. intraduktalen) Bestrahlung bei der palliativen Therapie eine gewisse Bedeutung zuzukommen scheint [10,13,16].…”

Section: Diskussionunclassified

Maligne Tumoren der Hepaticusgabel – Ergebnisse der chirurgischen Therapie und Prognosefaktoren

Beckurts

Hölscher

Bauer

et al. 1997

Chirurg

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Between 1 January 1986 and 31 December 1994, 45 patients with carcinoma of the hepatic bifurcation underwent operations in the department of surgery. According to Bismuth's classification (1992), there were 7 type I, 4 type II, 22 type III and 12 type IV tumors. 31 of the 45 patients (68.9%) underwent surgical resections with curative intentions: resection of the hepatic bifurcation (n = 9, 29%), resection of the hepatic bifurcation with hilar liver resection (n = 7, 22.6%), resection of the hepatic bifurcation with left hemihepatectomy (n = 10, 32.3%), orthotopic liver transplantation (n = 5, 16.1%). The remaining 14 patients underwent palliative (n = 6) or diagnostic (n = 8) operations. Two of the 45 patients (4.2%) died in hospital. Histological examination demonstrated R0 resection in 17 of 31 (54.8%) of the patients, while in the remaining 14 cases, only a R1/RX resection had been achieved. One-, 2- and 5-year survival rates were 75.4%, 53.9% and 24.5% (median survival: 729 days) in the 31 resected patients, and 30.8%, 10.3% and 0% (median survival: 153 days) in the palliative treatment group. A statistically significant influence on survival could be demonstrated for nodal status (N0/N1) and residual tumor status (R0/R1, R2).

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“…Still the long devices used for endoscopic stent placement are more prone to mechanical failure. Pre-cut papillotomy or standard papillotomy for very distal tumor positions must still be done fre quently for successful stent placement, but is no longer needed to treat a lesion above the papilla [7], Bilateral endoscopic metal stent placement in hilar lesions is extremely diffi cult and has been reported only occasionally [15]. …”

Section: Advantages/disadvantagesmentioning

confidence: 99%

“…It even facilitates percutaneous and en doscopic attempts to restore bile drainage be cause there is no need for stent removal. Although some have advocated diathermic cleaning or placement of a second metal stent, insertion of a polyethylene stent or an indwell ing catheter has proved to be very effective [15,33]. Davids et al [7] observed no recur rent jaundice after insertion of a polyethylene stent through a blocked stent, whereas after polyethylene stent exchange, the second stent clogged in almost 50% of patients.…”

Section: Reinterventionsmentioning

confidence: 99%

Metal Stents for Malignant Biliary Obstruction

Stoker²

1994

Dig Dis

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The main problem in the palliative treatment of malignant biliary obstruction is recurrent jaundice and cholangitis due to clogging of the endoprostheses. Large-bore metal stents, which can be placed using small-sized delivery systems, have been recognized as an important gain. Their use has facilitated the percutaneous drainage procedure. The long-term patency rates of both endoscopically and percutaneously placed metal stents seem to be better than those of conventional stents. Although the long-term economical aspects are in favor of metal stents due to the decreased need for readmissions and reinterventions, the high initial costs of metal stents constitute the main obstacle to their wide-spread use.

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Expandable biliary metal stents for malignancies: endoscopic insertion and diathermic cleaning for tumor ingrowth

Cited by 84 publications

References 15 publications

A New Method of Thermo-chemotherapy Using a Stent for Patients with Esophageal Cancer

A New Method of Thermo-chemotherapy Using a Stent for Patients with Esophageal Cancer

Maligne Tumoren der Hepaticusgabel – Ergebnisse der chirurgischen Therapie und Prognosefaktoren

Metal Stents for Malignant Biliary Obstruction

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