Utility of laser-cut covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a single-center experience

Marui, Saiko; Uza, Norimitsu; Yamazaki, Hajime; Ota, Sakiko; Nakamura, Toshiyasu; Yoshida, Hiroyuki; Okada, Hirokazu; Hirano, Toshio; Kuwada, Takeshi; Sogabe, Yuko; Tomono, Teruko; Matsumori, Tomoaki; Morita, Toshihiro; Nishikawa, Yoshihiro; Tsuda, Motoyuki; Maruno, Takahisa; Shiokawa, Masahiro; Kodama, Yuzo; Seno, Hiroshi

doi:10.1055/a-1149-1700

Cited by 14 publications

(20 citation statements)

References 7 publications

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“…Isayama et al and Marui et al reported stent migration rates of 12% and 4%, respectively. 35,37 However, the migration rate of the laser-cut-type CMSs remains unclear. Furthermore, few studies have examined whether the anti-migration features of biliary SEMSs prevent migration.…”

Section: Discussionmentioning

confidence: 99%

Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study

et al. 2022

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Background/Aims: Covered self-expandable metallic stents (CMSs) are widely used for malignant distal biliary obstructions (MDBOs) caused by pancreatic carcinoma. This study compared the efficacy and safety of the laser-cut-type and braided-type CMSs.Methods: To palliate MDBOs caused by pancreatic carcinoma, the laser-cut-type CMSs was used from April 2014 to March 2017, and the braided-type CMSs was used from April 2017 to March 2019. The tested self-expandable metallic stents were equipped with different anti-migration systems.Results: In total, 47 patients received CMSs for MDBOs (24 laser-cut type, 23 braided-type). The time to recurrent biliary obstruction (TRBO) was significantly longer in the braided-type CMSs (<i>p</i>=0.0008), and the median time to stent dysfunction or patient death was 141 and 265 days in the laser-cut-type CMSs and braided-type CMSs, respectively (<i>p</i>=0.0023). Stent migration was the major cause of stent dysfunction in both groups, which occurred in 37.5% of the laser-cut-type CMSs and 13.0% of the braidedtype CMSs. There were no differences in the survival duration between the groups.Conclusions: The TRBO was significantly longer for the braided-type CMSs with an anti-migration system than for the laser-cuttype. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.

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Section: Discussionmentioning

confidence: 99%

Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study

et al. 2022

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“…However, in a recent study by Marui et al, the authors have not used small-sized SEMS and they have not explored their benefits in hilar strictures, which require further exploration. 15 In this study, all except one LC-CSEMS were removed with snare or rat tooth forceps which points their potential use even in patients with benign biliary strictures.…”

Section: Commentarymentioning

confidence: 94%

“…Marui and colleagues, in a retrospective, observational, single-center study, explored a newer laser-cut FCSEMS (LC-CSEMS) for unresectable malignant distal biliary obstruction. 15 The new LC-CSEMS (X-Suit NIR covered biliary metal stent; Olympus Medical Systems, Tokyo, Japan) is 10 mm in diameter and 8 or 10 cm in length. 15,16 The stent has unique zigzag design composed of thick and thin struts made of nitinol.…”

mentioning

confidence: 99%

“…15 The new LC-CSEMS (X-Suit NIR covered biliary metal stent; Olympus Medical Systems, Tokyo, Japan) is 10 mm in diameter and 8 or 10 cm in length. 15,16 The stent has unique zigzag design composed of thick and thin struts made of nitinol. Thick struts maintain the stent form and provide a good radial force, and contribute to maintaining both SEMS position and the bile duct lumen.…”

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confidence: 99%

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Newer Stents for Unresectable Malignant Distal Biliary Obstruction: Striving for Perfection!

Shah

Rana

2021

Journal of Digestive Endoscopy

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Endoscopic biliary stenting is one of the most commonly used palliative procedure in patients with unresectable malignant distal biliary obstruction. Biliary stenting can be performed with either plastic or metallic stents. Stent occlusion and migration are important limitations of currently available stents. Variety of newer stents with varying designs and stent materials like stents with antimigratory properties, antireflux stents, drug-eluting stents, radioactive stents, and bioabsorbable stents are being developed to overcome the limitations of currently available stents. In this article, we are discussing two articles on the newer stent designs (plastic and metal stents) for biliary drainage in patients with unresectable malignant distal biliary obstruction.

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“…Although the advantage of the covered self-expandable metal stent is easy removal, it is thought that performing endoscopic removal of the laser-cut-self-expandable metal stent in cases of recurrent biliary obstruction is difficult due to its stent structure compared to that of the braided-covered self-expandable metal stent. However, recent studies have shown the possibility of endoscopic removal of the laser-cut self-expandable metal stent [ 48 , 49 , 50 , 51 ]. Moreover, the newly developed laser-cut-self-expandable metal stent, which has an anti-reflux valve to prevent duodenobiliary reflux, has been reported to be useful for patients with unresectable distal malignant biliary obstruction [ 52 , 53 ].…”

Section: Palliative Biliary Drainage For Patients With Unresectable Distal Malignant Biliary Obstructionmentioning

confidence: 99%

Current Status of Endoscopic Biliary Drainage in Patients with Distal Malignant Biliary Obstruction

Tanisaka

Mizuide

Fujita

et al. 2021

JCM

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Distal malignant biliary obstruction is caused by various malignant diseases that require biliary drainage. In patients with operable situations, preoperative biliary drainage is required to control jaundice and cholangitis until surgery. In view of tract seeding, endoscopic biliary drainage is the first choice. Since neoadjuvant therapies are being developed, the time to surgery is increasing, especially in pancreatic cancer cases. Therefore, it requires long stent patency. Recently, preoperative biliary drainage using self-expandable metal stents has been reported as a useful modality to secure long stent patency. In patients with unresectable distal malignant biliary obstruction, self-expandable metal stent is the first choice for maintaining long stent patency. Although there are many comparison studies between a covered and an uncovered self-expandable metal stent, their use is still controversial. Recently, endoscopic ultrasound-guided biliary drainage has been performed as an alternative treatment. The clinical success and stent patency are favorable. We should take into consideration that both endoscopic retrograde cholangiopancreatography-guided biliary drainage and endoscopic ultrasound-guided biliary drainage have advantages and disadvantages and chose the drainage method depending on the patient’s situation or the expertise of the endoscopist. Here, we discuss the current status of endoscopic biliary drainage in patients with distal malignant biliary obstruction.

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Utility of laser-cut covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a single-center experience

Cited by 14 publications

References 7 publications

Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study

Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study

Newer Stents for Unresectable Malignant Distal Biliary Obstruction: Striving for Perfection!

Current Status of Endoscopic Biliary Drainage in Patients with Distal Malignant Biliary Obstruction

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