Suspended over length biliary stents versus conventional plastic biliary stents for the treatment of biliary stricture

Abstract

To compare patency between suspended over length biliary stents (SOBSs; made from nasobiliary tube) and conventional plastic biliary stents (CPBSs). We retrospectively analyzed 61 patients with extrahepatic biliary stricture who underwent SOBS placement (intrahepatic bile duct) and 74 patients who underwent CPBS placement. Stent patency and complications were compared. The SOBS group was slightly older and contained more females than the CPBS group but other baseline characteristics were similar. Malignant biliary obstruction accounted for 57.4% (SOBS group) and 45.9% (CPBS group) of cases. Technical success rate, hospital stay and post-procedure complications were similar between groups. Median patency in the CPBS and SOBS group was 116 (2–360) days and 175 (3–480) days, respectively ( P <.001). The SOBS group had lower stent occlusion rates than the CPBS group at 3 months (9.8% vs 36.5%), 4 months (22.0% vs 55.4%), 5 months (35.6% vs 67.6%), and 6 months (39.3% vs 77.0%) (all P <.01). In Cox regression analysis, stent type (SOBS vs CPBS) was the only factor associated with patency (hazard ratio [HR]: 3.449; 95% CI: 1.973-6.028; P <.001). SOBS may have better medium-term patency than CPBS for benign/malignant biliary stricture.

Endoclip papillaplasty restores sphincter of Oddi function: Pilot study

“…Mechanical lithotripsy (ML; Trapezoid Rx; Boston Scientific) was performed for lithotripsy in case of stones larger than the diameter of the distal CBD, or if difficulty was encountered when using a Dormia basket for removal. A 7.5 Fr × 26 cm biliary plastic stent, a suspended overlength biliary stent made from a nasobiliary drainage tube (Boston Scientific), was placed to ensure that the biliary duct would not be clipped during endoclip papillaplasty and to reduce duodenobiliary reflux before follow‐up 7 …”

“…A 7.5 Fr 9 26 cm biliary plastic stent, a suspended overlength biliary stent made from a nasobiliary drainage tube (Boston Scientific), was placed to ensure that the biliary duct would not be clipped during endoclip papillaplasty and to reduce duodenobiliary reflux before follow-up. 7 The complete removal of choledocholithiasis was defined as the absence of any filling defect on balloon occlusion cholangiogram after negative ductal swept by balloon and/or basket. Prophylactic pancreatic stent was placed in the conditions where the guidewire was placed into the pancreatic duct three times and/or the pancreatic duct sphincter was pre-cut.…”

Changing Trends in Biliary Stenting for Unresectable Malignant Perihilar Obstructions

“…9 On the contrary, a Chinese study by Yan et al highlighted that over length suspended plastic stents have improved patency periods compared to conventional plastic stents. 10 Again, this study was retrospective and single center based with a limited number of patients and the results cannot be generalized.…”

“…In a RCT study conducted in Denmark by Pedersen et al, it was concluded that there was increased stent migration among the stents placed above the sphincter of Oddi compared to the transpapillary approach ( p =0.026), whereas no difference in overall stent performance was noted among the two groups [ 9 ]. On the contrary, a Chinese study by Yan et al highlighted that over length suspended plastic stents have improved patency periods compared to conventional plastic stents [ 10 ]. Again, this study was retrospective and single center based with a limited number of patients and the results cannot be generalized.…”

The first case to decompress the pancreatic duct by reopening a surgical cystogastrostomical fistula using EUS–guided pancreatic drainage

“…However, the interventions were repeated monthly because of stent migrations. After several failing attempts at stent secure schemes, using clips with nylon drawstrings at both the proximal and distal ends, we finally fasten a 7F 200-mm stent (remolded from our suspended overlength biliary stent [ 1 ] ) at the gastric wall [Figure 4 ]. The patient had remained asymptomatic until now.…”