Suprapapillary versus Transpapillary Stent Placement for Malignant Biliary Obstruction: Which Is Better?

Jo, Jeong-Hyun; Park, Byeong-Ho

doi:10.1016/j.jvir.2014.11.043

Cited by 29 publications

(25 citation statements)

References 25 publications

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“…Technical aspects of metal stent placement are best planned using preliminary MRCP or CT, particularly for hilar malignant obstruction. 48 Considerations when performing metal stent placement include preserving the papilla if possible to avoid ascending cholangitis and to improve long-term patency, 51,52 minimizing distention of the gallbladder to avoid postprocedure cholecystitis, and avoiding the caging of branch points, if possible, to avoid associated biliary obstruction. Prior to stent placement, balloonassisted clearance of sludge from the biliary tree may reveal a shorter segment of malignant involvement and allow placement of a shorter stent.…”

Section: Self-expanding Metal Stentsmentioning

confidence: 99%

Management of Malignant Biliary Obstruction

Lorenz

2016

Semin intervent Radiol

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The diagnosis of malignant biliary obstruction combines the use of clinical evaluation, diagnostic imaging, tissue sampling, and minimally invasive options with the initial goal of identifying candidates for curative resection. The most common causes of obstruction are pancreatic adenocarcinoma and cholangiocarcinoma, and most cases are too advanced for surgical options. Interventional radiologists and gastroenterologists offer palliative options for biliary drainage such as plastic stents and catheters, bare metal stents, and covered stents. This article provides an updated review of options and outcomes for the management of malignant biliary obstruction.

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Section: Self-expanding Metal Stentsmentioning

confidence: 99%

Management of Malignant Biliary Obstruction

Lorenz

2016

Semin intervent Radiol

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“…[ 5 6 ] Currently, concerns exist over whether stent placement above SO causes more early cholangitis, stent occlusion, or reduced survival. Studies to compare efficiency of placement to treat MBO [ 6 7 8 9 10 11 ] have not been conclusive with regard to impaired SO function and resulting cholangitis. [ 5 12 ]…”

Section: Introductionmentioning

confidence: 99%

“…Those with hilar strictures were treated with a suprapapillary method. [ 6 8 13 14 ] Study data so far cannot be easily compared, so no conclusion exists to suggest the optimal stent placement, especially for those with distal biliary obstruction ≥2 cm from the SO. [ 5 7 ]…”

Section: Introductionmentioning

confidence: 99%

Differences in efficacy of uncovered self-expandable metal stent in relation to placement in the management of malignant distal biliary obstruction

Zhang

Liu

et al. 2018

Saudi J Gastroenterol

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Background/Aims:Metal stent insertion is a common palliative treatment for distal malignant biliary obstruction (MBO) but whether placement across the sphincter of Oddi (SO) causes more complications or shorter survival is in question. The aim of this study was to compare the clinical outcomes of percutaneous uncovered self-expandable metal stent placement above and across the SO in patients with distal MBO.Patients and Methods:We retrospectively studied 59 patients who underwent uncovered metal stent placement for distal MBO between January 2012 and March 2016. Stents were placed above the SO for 22 subjects (group A) and across the SO for 37 subjects (group B). Early cholangitis, stent occlusion, and overall survival time were compared between the two groups.Results:Clinical success was 90.9 and 86.5% for groups A and B, respectively. Early cholangitis occurred in 2 patients (9.1%) in group A and in 6 patients (16.2%) in group B (P = 0.645). Median stent patency and median survival time was 105 and 140 days for group A, 120 and 160 days for group B, respectively. The stent occlusion (31.8% in group A and 21.6% in group B, P = 0.454) and the cumulative stent patency times (P = 0.886) did not differ between the two groups. There was no significant difference in cumulative patient survival between the two groups (P = 0.810).Conclusion:Uncovered metal stent placement across the SO did not significantly affect early cholangitis, stent patency, or patient survival.

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“…Another potential benefit of suprapapillary catheters (or stents) is a decreased risk of procedure-related pancreatitis. 28 As long as there are side holes above and below the obstruction (►Fig. 3), these catheters can function as internal/external drains.…”

Section: Hilar Biliary Obstruction and The Papillamentioning

confidence: 99%

Palliative Percutaneous Biliary Interventions in Malignant High Bile Duct Obstruction

Deipolyi

Covey

2017

Semin intervent Radiol

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The optimal palliative intervention for malignant biliary obstruction is internal drainage by placement of a metallic stent. For patients with hilar biliary obstruction or low bile duct obstruction in whom endoscopy is not feasible, a percutaneous transhepatic approach in interventional radiology is preferred. This article reviews the rationale for this approach, periprocedural management, and techniques to optimize stent patency.

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Suprapapillary versus Transpapillary Stent Placement for Malignant Biliary Obstruction: Which Is Better?

Cited by 29 publications

References 25 publications

Management of Malignant Biliary Obstruction

Management of Malignant Biliary Obstruction

Differences in efficacy of uncovered self-expandable metal stent in relation to placement in the management of malignant distal biliary obstruction

Palliative Percutaneous Biliary Interventions in Malignant High Bile Duct Obstruction

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