Risk factors for technical failure of endoscopic double self‐expandable metallic stent placement by partial stent‐in‐stent method

Abstract

Metastatic disease was a significant risk factor for technical failure of double SEMS placement for unresectable MHBO. The laser-cut type SEMS with a large mesh and thin delivery system might be preferable for the PSIS procedure.

Reintervention for stent occlusion after bilateral self‐expandable metallic stent placement for malignant hilar biliary obstruction

“…Self‐expandable metallic stents are superior to PS when carrying out biliary drainage to treat unresectable MHBO . However, opinions are yet to be established regarding drainage area, placement method, and optimal stent type . With regard to the drainage area, Mukai et al .…”

“…1,2 However, opinions are yet to be established regarding drainage area, 1,14 placement method, 15,16 and optimal stent type. [17][18][19] With regard to the drainage area, Mukai et al 1 revealed that there was no significant difference between unilateral and bilateral placement in relation to the duration of stent patency, but approximately half of the patients required bilateral drainage. Unilateral drainage may not provide adequate drainage, and bilateral drainage might be more effective physiologically for stent patency.…”

Predictive factors for the failure of endoscopic stent-in-stent self-expandable metallic stent placement to treat malignant hilar biliary obstruction

“…Few reports have examined the relationship between failure to place an endoscopic stent-in-stent SEMS and the characteristics of the patients. In one report, metastatic disease was found to be related to the failure to place an endoscopic stent-in-stent SEMS[ 17 ]. Although a similar number of patients who were evaluated in the previous investigation were analysed in this study, different results were obtained.…”

8-mm versus 10-mm diameter self-expandable metallic stent in bilateral endoscopic stent-in-stent deployment for malignant hilar biliary obstruction

“…We consider that delayed insertion of the second SEMS by several days following the expansion of the first SEMS may also enhance the success rate of SIS deployment. Recently, Kawakubo et al described the risk factors for technical failure of SIS deployment. The rate of technical success after double guide‐wire insertion was greater when using a laser‐cut‐type SEMS with a large mesh and thin delivery system compared to the braided‐type SEMS with a small mesh and thick delivery system.…”