The management of occluded metallic self-expandable biliary endoprostheses.

Jackson, JE; Roddie, Mary E.; Chetty, Naren; Benjamin, I. S.; Adam, Andreas

doi:10.2214/ajr.157.2.1713017

Cited by 18 publications

(4 citation statements)

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“…The increased rate of technical success approached statistical significance ( P = 0.09996), but the higher rate of adequate drainage failed to do so ( P = 0.2127). This is most likely a result of the insufficient sample size rather than the lack of a true trend, and agrees with results in other published series 4,5,28,42,52,53,66,67 . Of note, in the two trials performed to date, one reported greater success with metal stents, the other with plastic.…”

Section: Discussionsupporting

confidence: 89%

“…This is most likely a result of the insufficient sample size rather than the lack of a true trend, and agrees with results in other published series. 4,5,28,42,52,53,66,67 Of note, in the two trials performed to date, one reported greater success with metal stents, the other with plastic. The differences in these trials were very small (1-2%), however, and were not statistically significant.…”

Section: Most Operators Agree the Narrow 7-fr Wallstent Insertionmentioning

confidence: 99%

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Role of radiology in the treatment of malignant hilar biliary strictures 2: 10 years of single‐institution experience with percutaneous treatment

Hii

Gibson

Speer

et al. 2003

Australasian Radiology

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We reviewed the results of percutaneous intervention of hilar biliary malignancy over a 10-year period at a single institution: the Royal Melbourne Hospital. Ninety-nine patients (100 treated in total) were included. Information was retrieved by retrospective examination of patient notes and radiology, combined with interviews with family and relevant physicians. Sixty-nine patients were treated with insertion of semipermanent stents, 19 had external drain tubes, and 25 received percutaneous access for Iridium brachytherapy. Adequate drainage was achieved in 87% of the patients stented, and percutaneous access was successful in 96% of patients planned for brachytherapy. Of those patients undergoing endoprosthesis insertion, early complications occurred in 39% and late complications in 23%. Average survival for the entire patient population was 227.3 days, with a median of 167 days. Longer survival times (213 vs 142 days) and lower complication rates (44 vs 64%) are observed with metal stents in comparison with plastic stents. Percutaneous intervention is an important treatment option in hilar biliary malignancy, particularly in patients unfit for surgery. Reasonable survival with good palliation is the most common outcome, and most patients do not require further intervention.

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Section: Discussionsupporting

confidence: 89%

Section: Most Operators Agree the Narrow 7-fr Wallstent Insertionmentioning

confidence: 99%

Role of radiology in the treatment of malignant hilar biliary strictures 2: 10 years of single‐institution experience with percutaneous treatment

Hii

Gibson

Speer

et al. 2003

Australasian Radiology

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“…In cases of tumor overgrowth the second endoprosthesis must extend beyond the mass which is responsible for the occlusion of the first stent [11]. Unlike plastic stents, Wallstent endoprostheses rarely become occluded by encmsted bile.…”

Section: Complicationsmentioning

confidence: 99%

Metallic biliary endoprostheses

Adam

1994

Cardiovasc Intervent Radiol

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In patients with obstructive jaundice caused by unresectable malignant tumors, biliary endoprostheses inserted percutaneously or endoscopically can provide excellent palliation. Conventional plastic stents are associated with a relatively high rate of occlusion caused by biliary sludge. Migration is another significant problem. Self-expandable, metallic stents can be inserted percutaneously via a small transhepatic track but expand to achieve a relatively large internal diameter. This minimizes the problem of occlusion due to encrusted bile and reduces the rate of reintervention. Migration rarely occurs. Metallic stents have also been employed in the management of recurrent benign biliary strictures unsuitable for surgery. In those patients in whom the frequency of radiological intervention is unacceptably high, such endoprostheses can provide a means of preventing restenosis.

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“…All types have been first deployed through the percutaneous transhepatic route [27][28][29][30][31][32] and some have not yet become available in an endoscopically usable form.…”

Section: Metallic Expandable Endoprosthesesmentioning

confidence: 99%

Pancreatic Cancer: Stenting versus Surgery

Can-Locke¹

1994

Dig Surg

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Endoscopic palliation of malignant biliary obstruction due to pancreatic cancer has become an accepted alternative to surgical bilioenteric bypass over the last decade. Clinical experience and randomized trials have shown equal efficacy with lower initial morbidity and mortality rates for endoscopic biliary stent therapy but the problem of stent occlusion remains as the dominant late problem. Metallic stents have an improved patency rate and are cost-effective. Newer applications of endoscopically-placed stents for pancreatic pain and gastric outlet obstruction are being explored. The place of laparoscopic approaches to the consequences of pancreatic cancer has yet to be defined.

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The management of occluded metallic self-expandable biliary endoprostheses.

Cited by 18 publications

References 0 publications

Role of radiology in the treatment of malignant hilar biliary strictures 2: 10 years of single‐institution experience with percutaneous treatment

Role of radiology in the treatment of malignant hilar biliary strictures 2: 10 years of single‐institution experience with percutaneous treatment

Metallic biliary endoprostheses

Pancreatic Cancer: Stenting versus Surgery

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