The role of covered self-expandable metallic stents in malignant biliary strictures

Leung, Joseph; Rahim, N.

doi:10.1016/j.gie.2006.02.011

Cited by 12 publications

(6 citation statements)

References 16 publications

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“…Endoscopic stent placement using self-expandable metal stents (SEMS) is an established method of palliative treatment for relieving obstructive jaundice in patients with unresectable pancreatobiliary malignancies 7,16. SEMS were introduced at the end of the 1980s to overcome the disadvantages of plastic stents with respect to patency and durability 17-20.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy Prolongs Biliary Metal Stent Patency in Malignant Pancreatobiliary Obstructions

Park

Park²,

Bang

et al. 2013

Gut Liver

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Background/AimsBiliary stenting is the most effective decompressive method for treating malignant biliary obstructive jaundice. Although the main cause of stent occlusion is tumor growth, few studies have investigated whether stent patency is affected by the combination of cancer-treatment modalities. The aim of this study was to evaluate the effects of local radiotherapy on metal-stent patency in patients with malignant biliary obstruction.MethodsPatients who underwent self-expandable biliary metallic stenting for malignant biliary obstruction from 1999 to 2007 were included. Forty patients received chemotherapy and radiation therapy (radiation group, RG), and 31 patients received only chemotherapy (nonradiation group, NRG).ResultsThe cumulative median stent patency was significantly longer in the RG than in the NRG (17.7 months; 95% confidence interval [CI], 1.8 to 33.6 months vs 8.7 months; 95% CI, 4.9 to 12.5 months; p=0.025). Stent occlusion caused by tumor growth or stent migration occurred in two (5%) and three (7.5%) cases in the RG and in six (19.3%) and two (6.5%) cases in the NRG, respectively.ConclusionsThe patency of biliary metal stents in pancreatobiliary cancer patients who receive chemoradiation therapy is significantly longer than that in patients who do not receive radiotherapy, which suggests that local cancer control significantly affects stent patency.

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Section: Discussionmentioning

confidence: 99%

Radiotherapy Prolongs Biliary Metal Stent Patency in Malignant Pancreatobiliary Obstructions

Park

Park²,

Bang

et al. 2013

Gut Liver

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“…Although covered stents are designed to overcome tissue ingrowth, failure to embed in the bile duct wall can result in proximal and distal migration, at a reported frequency of 6%8% [1][2][3][4][5] . Migration of a biliary SEMS may occur proximally or distally after stent insertion and may cause complications such as ulceration, perforation and intestinal obstruction [1][2][3] . Generally, correct positioning of the SEMS at the initial stent placement is important in preventing migration.…”

Section: Discussionmentioning

confidence: 99%

“…However, complications such as tumor ingrowth, overgrowth, food debris, and mucosal hyperplasia can occur. The use of covered SEMS is clearly effective in preventing tumor ingrowth [1][2][3] . Nevertheless, in two recently published randomized trials of covered versus uncovered metal biliary stents, outcomes such as stent patency were no different between the two stents but the risk of migration was higher with the covered stents [4,5] .…”

Section: Introductionmentioning

confidence: 99%

Stent-in-stent through a side hole to prevent biliary metallicstent migration

Ridtitid

Rerknimitr²,

Amornsawadwattana³

et al. 2011

WJGE

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The covered selfexpandable metallic stent (SEMS) has been developed to overcome the problem of tissue in growth, However, stent migration is a wellknown com plication of covered SEMS placement. Use of a double pigtail stent to lock the movement of the SEMS and prevent migration has been advised by many experts. Unfortunately, in our case this technique led to an in cidental upward migration of the SEMS. We used APC to create a side hole in the SEMS for plastic stent insertion as stentinstent. This led to a successful prevention of stent migration.

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“…term patency in malignant stenoses and carry a low risk of tissue ingrowth and sludge accumulation [1,4,5]. This sup− ports the feasibility of intentional retriev− al and allows the endoscopist greater lati− tude when extended time periods of stent placement are necessary [1].…”

Section: Videomentioning

confidence: 99%

Biliary stenting and successful intentional stent retrieval after 6 months in a benign stricture following hepaticojejunostomy

Renteln¹,

Riecken²,

Ulmer³

et al. 2007

Endoscopy

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The role of covered self-expandable metallic stents in malignant biliary strictures

Cited by 12 publications

References 16 publications

Radiotherapy Prolongs Biliary Metal Stent Patency in Malignant Pancreatobiliary Obstructions

Radiotherapy Prolongs Biliary Metal Stent Patency in Malignant Pancreatobiliary Obstructions

Stent-in-stent through a side hole to prevent biliary metallicstent migration

Biliary stenting and successful intentional stent retrieval after 6 months in a benign stricture following hepaticojejunostomy

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