Risk Factors of Duodenobiliary Reflux-Related Dysfunction of Covered Biliary Metal Stents after Treatment of Duodenal Stricture in Patients with Malignant Biliary and Duodenal Obstruction

Wu, Chi-Huan; Lee, Mu-Hsien; Tsou, Yung-Kuan; Lin, Chao‐Nan; Sung, Kai-Feng; Pan, Kuang-Tse; Liu, Nai‐Jen

doi:10.3390/curroncol28050319

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…A retrospective study assessing patients who underwent double stenting showed that duodenal stent dysfunction and the biliary stent end located above the duodenal stent were risk factors for biliary stent dysfunction (89). A similar study by Taiwanese researchers reported that duodenal obstruction below the papilla and a score of ≤2 on the GOOSS (20) after treatment for duodenal obstruction were associated with DBR-related biliary CSEMS dysfunction (90). More attention should be paid to formulating a treatment strategy for patients with combined biliary and duodenal obstruction, considering the possible risk of developing DBR.…”

Section: Choice Of Biliary Intervention In Cases With Coexisting Bili...mentioning

confidence: 96%

How to successfully administer palliative treatment with a stent for malignant gastric outlet obstruction?

Maetani

2022

Front. Med.

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Although endoscopic stenting (ES) has been widely used as a less-invasive palliation method for malignant gastric outlet obstruction (GOO), recent reports have highlighted issues related to the procedure. For successful treatment, various aspects must be assessed before considering the practices. First, it is necessary to eliminate cases with contraindications such as coexistence of distal small-bowel obstruction or perforation. Other factors potentially related to clinical failure (i.e., peritoneal carcinomatosis) may require consideration but remain controversial. ES has better short-term outcomes than surgical gastrojejunostomy (GJ). GJ has recently been considered preferable in cases with longer life expectancy because of superior sustainability. Various types of stents are now commercially available, but their ideal structure and mechanical properties have not yet been clarified. Covered metal stent may reduce stent obstruction but is prone to increase stent migration, and its significance remains uncertain. Subsequent chemotherapy after stenting should be considered, as it is expected to prolong patient survival without increasing the risk of adverse events. Furthermore, it may be helpful in preventing tumor ingrowth. In cases with GOO combined with biliary obstruction, biliary intervention is often difficult. Recently, endoscopic ultrasound-guided biliary drainage (EUS-BD) has been widely used as an alternative procedure for endoscopic transpapillary biliary drainage (ETBD). Despite the lack of consensus as to whether ETBD or EUS-BD is preferred, EUS-BD is useful as a salvage technique for cases where ETBD is difficult. To perform stent placement successfully, it is important to pay attention to the above points; however, many remaining issues need to be clarified in the future.

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Section: Choice Of Biliary Intervention In Cases With Coexisting Bili...mentioning

confidence: 96%

How to successfully administer palliative treatment with a stent for malignant gastric outlet obstruction?

Maetani

2022

Front. Med.

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“…Thus, one of the main reasons for cholangitis being one of the most serious complications of minimally invasive BD decompression techniques, is stent occlusion, which is strongly associated with duodenobiliary reflux. Therefore, avoidance of duodenobiliary reflux is important in preventing stent dysfunction and cholangitis onset[ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a new approach to minimally invasive surgery in palliative treatment of patients with distal malignant biliary obstruction

Susak¹,

Markulan²,

Lobanov³

et al. 2023

World J Gastrointest Surg

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BACKGROUND Palliative endoscopic biliary drainage is the primary treatment option for the management of patients with jaundice which results from distal malignant biliary obstruction (DMBO). In this group of patients, decompression of the bile duct (BD) allows for pain reduction, symptom relief, chemotherapy administration, improved quality of life, and increased survival rate. To reduce the unfavorable effects of BD decompression, minimally invasive surgical techniques require continuous improvement. AIM To develop a technique for internal-external biliary-jejunal drainage (IEBJD) and assess its effectiveness in comparison to other minimally invasive procedures in the palliative treatment of patients with DMBO. METHODS A retrospective analysis of prospectively collected data was performed, which included 134 patients with DMBO who underwent palliative BD decompression. Biliary-jejunal drainage was developed to divert bile from the BD directly into the initial loops of the small intestine to prevent duodeno-biliary reflux. IEBJD was carried out using percutaneous transhepatic access. Percutaneous transhepatic biliary drainage (PTBD), endoscopic retrograde biliary stenting (ERBS), and internal-external transpapillary biliary drainage (IETBD) were used for the treatment of study patients. Endpoints of the study were the clinical success of the procedure, the frequency and nature of complications, and the cumulative survival rate. RESULTS There were no significant differences in the frequency of minor complications between the study groups. Significant complications occurred in 5 (17.2%) patients in the IEBJD group, in 16 (64.0%) in the ERBS group, in 9 (47.4%) in the IETBD group, and in 12 (17.4%) in the PTBD group. Cholangitis was the most common severe complication. In the IEBJD group, the course of cholangitis was characterized by a delayed onset and shorter duration as compared to other study groups. The cumulative survival rate of patients who underwent IEBJD was 2.6 times higher in comparison to those of the PTBD and IETBD groups and 20% higher in comparison to that of the ERBS group. CONCLUSION IEBJD has advantages over other minimally invasive BD decompression techniques and can be recommended for the palliative treatment of patients with DMBO.

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Percutaneous insertion of long-covered biliary stents in patients with malignant duodenobiliary stricture

Gwon

Chu

et al. 2023

Eur Radiol

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Risk Factors of Duodenobiliary Reflux-Related Dysfunction of Covered Biliary Metal Stents after Treatment of Duodenal Stricture in Patients with Malignant Biliary and Duodenal Obstruction

Cited by 3 publications

References 27 publications

How to successfully administer palliative treatment with a stent for malignant gastric outlet obstruction?

How to successfully administer palliative treatment with a stent for malignant gastric outlet obstruction?

Effectiveness of a new approach to minimally invasive surgery in palliative treatment of patients with distal malignant biliary obstruction

Percutaneous insertion of long-covered biliary stents in patients with malignant duodenobiliary stricture

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