Mechanisms and prevention of biliary stent occlusion

Шабунин, А. В.; Tavobilov, Mikhail; Лебедев, С. С.; Карпов, А. А.

doi:10.17116/hirurgia202005170

Cited by 3 publications

(2 citation statements)

References 67 publications

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“…The main cause of bleeding is the obscuration of the puncture path of PTCD and the inadvertent puncture of the patient’s blood vessels during the puncture. The bleeding is caused by the blinding of the puncture path of PTCD, and inadvertent puncture of the patient’s blood vessels during the puncture ( 36 ). The infection may be secondary to the reflux of duodenal fluid or to an associated poor drainage process, while ERCP is more likely to cause acute pancreatitis ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

The clinical efficacy and safety of different biliary drainage in malignant obstructive jaundice: a meta-analysis

Wang,

Zhao,

She

et al. 2024

Front. Oncol.

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BackgroundCurrently, percutaneous transhepatic cholangial drainage (PTCD) and endoscopic retrograde cholangiopancreatography (ERCP) are commonly employed in clinical practice to alleviate malignant obstructive jaundice (MOJ). Nevertheless, there lacks a consensus regarding the superiority of either method in terms of efficacy and safety.AimTo conduct a systematic evaluation of the effectiveness and safety of PTCD and ERCP in treating MOJ, and to compare the therapeutic outcomes and safety profiles of these two procedures.MethodsCNKI, VIP, Wanfang, CBM, PubMed, Web of Science, Embase, The Cochrane Library, and other databases were searched for randomized controlled trials (RCTs) on the use of PTCD or ERCP for MOJ. The search period was from the establishment of the databases to July 2023. After quality assessment and data extraction from the included studies, Meta-analysis was performed using RevMan5.3 software.ResultsA total of 21 RCTs involving 1,693 patients were included. Meta-analysis revealed that there was no significant difference in the surgical success rate between the two groups for patients with low biliary obstruction (P=0.81). For patients with high biliary obstruction, the surgical success rate of the PTCD group was higher than that of the ERCP group (P < 0.0001), and the overall surgical success rate of the PTCD group was also higher than that of the ERCP group (P = 0.008). For patients with low biliary obstruction, the rate of jaundice relief (P < 0.00001) and the clinical efficacy (P = 0.0005) were better in the ERCP group, while for patients with high biliary obstruction, the rate of jaundice relief (P < 0.00001) and the clinical efficacy (P = 0.003) were better in the PTCD group. There was no significant difference in the overall jaundice remission rate and clinical efficacy between the two groups (P = 0.77, 0.53). There was no significant difference in the reduction of ALT, TBIL, and DBIL before and after surgery and the incidence of postoperative complications between the two groups (P > 0.05).ConclusionBoth PTCD and ERCP can efficiently alleviate biliary obstruction and enhance liver function. ERCP is effective in treating low biliary obstruction, while PTCD is more advantageous in treating high biliary obstruction.

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Section: Discussionmentioning

confidence: 99%

The clinical efficacy and safety of different biliary drainage in malignant obstructive jaundice: a meta-analysis

Wang,

Zhao,

She

et al. 2024

Front. Oncol.

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“…Noncovered metal biliary stent placement (BSP) is a widely recognized and favored drainage method for the treatment of unresectable malignant biliary stenosis ( 2 , 3 ). However, BSP can only mechanically relieve high bile duct pressure and has no therapeutic effect on the primary tumors; moreover, over time, factors such as tumor in-growth, bile duct sludge formation (food residue or unknown origin), and biofilm formation often result in a median stent patency time of only approximately 3–6 months ( 4 , 5 ). Therefore, the long-term efficacy of treatments for malignant biliary stenosis urgently needs to be improved.…”

Section: Introductionmentioning

confidence: 99%

Clinical application of the retrograde track method in reopening dysfunctional biliary stents

Hou,

Song,

Zhou

et al. 2024

Quant Imaging Med Surg

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Background Biliary stent dysfunction is challenging to treat in clinic. The retrograde track method (RTM) has a promising clinical application in the reopening of dysfunctional biliary stents. This study aimed to evaluate the clinical value of the RTM in reopening dysfunctional biliary stents. Methods From February 2013 to January 2020, 151 patients underwent percutaneous transhepatic biliary interventional procedures for reopening dysfunctional biliary stents at the First Affiliated Hospital of Zhengzhou University, and 25 patients (12 females, 13 males; mean age 63.12 years old) underwent the RTM after anterograde reopening dysfunction biliary stent failure. Technical success, clinical success, irradiation dose, procedure time, complications, and overall survival (OS) were recorded, and levels of total bilirubin (TBIL), direct bilirubin (DB), alanine aminotransferase (ALT), albumin (ALB), and carbohydrate antigen-199 (CA-199) were compared before treatment and 1 month after treatment. Results The technical and clinical success rates were 100% and 96%, respectively, and the irradiation dose and procedure times were 774.07±330.80 mGy and 45.16±9.48 min, respectively. Two patients (8%) experienced major complications. The median OS was 10.73 months [95% confidence interval (CI): 9.37–12.09]. Compared with pretreatment values, the mean levels at 1 month after RTM administration for TBIL (189.47±59.20 vs . 44.65±16.12 µmol/L), DB (144.21±55.83 vs . 27.95±13.86 µmol/L), ALT (89.62±30.85 vs . 49.44±14.25 U/L), and CA-199 (584.59±269.82 vs . 176.76±100.68 U/mL) showed significant decreases, while that of ALB (36.32±2.05 vs . 40.22±1.95 g/L) showed a significant increase (all P values <0.05). Conclusions RTM is an effective alternative treatment method when anterograde reopening of a dysfunctional biliary stent occurs.

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Advances in the Interventional Treatment of Malignant Obstructive Jaundice

王

2023

ACM

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Mechanisms and prevention of biliary stent occlusion

Cited by 3 publications

References 67 publications

The clinical efficacy and safety of different biliary drainage in malignant obstructive jaundice: a meta-analysis

The clinical efficacy and safety of different biliary drainage in malignant obstructive jaundice: a meta-analysis

Clinical application of the retrograde track method in reopening dysfunctional biliary stents

Advances in the Interventional Treatment of Malignant Obstructive Jaundice

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