Self-Expanding Metal Stents (SEMS) for Preoperative Biliary Decompression in Patients with Resectable and Borderline-Resectable Pancreatic Cancer: Outcomes in 241 Patients

Siddiqui, Ali A.; Mehendiratta, Vaibhav; Loren, David E.; Kowalski, Thomas E.; Fang, John C.; Hilden, Kristen; Adler, Douglas G.

doi:10.1007/s10620-012-2482-z

Cited by 52 publications

(41 citation statements)

References 29 publications

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“…There have been some reports regarding late complications of biliary SEMS placement such as bile duct perforation due to mechanical pressure by a SEMS and hepatic abscess due to 3 stent occlusion. [1][2][3] This is the first report of an extrahepatic abscess at the eccentric site as a late complication of SEMS placement. The eccentric abscess can result from a combination of SEMS placement and neoadjuvant chemoradiation that will contribute to tissue damage and delayed healing at the bile duct.…”

mentioning

confidence: 79%

Eccentric Abscess Due to Bile Duct Microperforation Caused by Self-expandable Metal Stent and Neoadjuvant Chemoradiation

Kuwatani

Kawamoto

Nakamura

2016

Clinical Gastroenterology and Hepatology

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mentioning

confidence: 79%

Eccentric Abscess Due to Bile Duct Microperforation Caused by Self-expandable Metal Stent and Neoadjuvant Chemoradiation

Kuwatani

Kawamoto

Nakamura

2016

Clinical Gastroenterology and Hepatology

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“…Mean time between stent placement and surgery to relieve hyperbilirubinemia and provide patients with an optimal nutritional status was 4 weeks (3,26). With a retrospective design and lacking a control group, Singal et al demonstrated that placing a metallic stent added no technical difficulties during surgery, and was a safe and effective measure in the setting of resectable or potentially resectable neoplastic lesions following cancer therapy (3,27).…”

Section: Preoperative Drainage Preliminary Studiesmentioning

confidence: 99%

Endoscopic management of malignant biliary stenosis. Update and highlights for standard clinical practice

Mj¹,

Ma²

2016

Rev Esp Enferm Dig

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The present review describes the various indications of biliary stent placement in patients with biliary malignancies. It deals in depth with biliary accesses and their effectiveness, as well as with the use of different stents according to lesion type and expected patient survival. For liver hilum lesions, which are somewhat more complex, the usefulness of and need for unilateral or bilateral drainage is assessed, as it is the most appropriate method. All in all, this is an up-to-date literature review that may help clinicians in their daily decision-making, as well as to improve and optimize patient outcomes.

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“…35,36 SEMS have also been shown to be better than plastic stents for palliative stenting as well. A Cochrane database review evaluated nine studies that compared the stent materials.…”

Section: Q3mentioning

confidence: 99%

Management of malignant distal biliary obstruction

Cassani

Lee

2015

Gastrointestinal Intervention

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a b s t r a c tThe most common cause of malignant distal biliary obstruction is pancreatic cancer, as 70-90% of patients will develop jaundice during the course of their disease. Pancreatic cancer is usually advanced at presentation, and curative resection is possible in < 15% of patients. If a patient is to undergo early surgical resection, biliary drainage is not prerequisite. Early surgery without preoperative biliary drainage does not increase the risk of complications, as compared with preoperative biliary drainage, followed by surgery. Postoperative complications do not differ significantly between the two approaches. In light of no significant improvements in patient survival in large trials of a surgery-first followed by adjuvant therapy over the past 2 decades, there has been a shift towards preoperative neoadjuvant chemotherapy in the setting of borderline resectable disease. Consequently, effective preoperative biliary drainage has become a paramount concern in this setting. Multiple retrospective and prospective studies have compared the outcomes between covered metal stents and uncovered metal stents in malignant biliary obstruction. In patients undergoing neoadjuvant chemoradiation or surgical resection, no significant self-expanding metal stent-related complications or adverse events were seen. Additionally, no significant difference in overall survival was seen between the two groups. Within the palliative realm, self-expanding metal stents have also become the stent of choice with greater duration of patency. In an effort to deliver a survival benefit, there are many ongoing trials and developments in the realm of the therapeutic endoscopy. In this review, we will examine what we have accomplished and further explore the potential benefits of endoscopic interventions on the horizon.

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Self-Expanding Metal Stents (SEMS) for Preoperative Biliary Decompression in Patients with Resectable and Borderline-Resectable Pancreatic Cancer: Outcomes in 241 Patients

Abstract: SEMS should be considered for patients with obstructive jaundice and resectable or borderline resectable pancreatic cancer, especially if surgery is not planned immediately as a result of preoperative chemoradiation. These stents appear to be safe and effective.

Cited by 52 publications

References 29 publications

Eccentric Abscess Due to Bile Duct Microperforation Caused by Self-expandable Metal Stent and Neoadjuvant Chemoradiation

Eccentric Abscess Due to Bile Duct Microperforation Caused by Self-expandable Metal Stent and Neoadjuvant Chemoradiation

Endoscopic management of malignant biliary stenosis. Update and highlights for standard clinical practice

Management of malignant distal biliary obstruction

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