A Preliminary Study on the Usefullness of a Zilver Stent for Bilateral Stenting in Patients withAdvanced Hilar Cholangiocarcinoma.
- Author:
Jae Sup EUM
1
;
Dae Hwan KANG
;
Cheol Woong CHOI
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. sulsulpul@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Y stent;
Zilver stent;
Hilar cholangiocarcinoma
- MeSH:
Bismuth;
Cholangiocarcinoma;
Constriction, Pathologic;
Hepatic Duct, Common;
Humans;
Prognosis;
Recurrence;
Stents
- From:Korean Journal of Gastrointestinal Endoscopy
2008;36(6):354-360
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Hilar cholangiocarcinomas have an extremely poor prognosis. Although endoscopic bilateral metal stenting with the "stent in stent" technique using a Y stent is currently employed to treat patients with an unresectable hilar cholangiocarcinoma, this method has limited application in cases of tight strictures. Furthermore, insertion of stents into the Y stent side (first stent side) is problematic in cases of tumor recurrence. We evaluated the clinical efficacy of the use of endoscopic bilateral metal stenting with the Zilver stent. METHODS: Seven patients with an unresectable Bismuth type III or IV hilar cholangiocarcinoma were included in this study. For endoscopic bilateral metal stenting, we first inserted a Y stent with a central wide-open mesh. The Zilver stent was placed into the contralateral hepatic duct through the central portion of the Y stent. RESULTS: Both technical and functional success was achieved in seven patients (100%). The early complication rate was 0%, and late complications due to tumor recurrence occurred in 2 out of 7 (28.6%) patients. These patients were managed by the placement of additional stents or with the use of percutaneous transhepatic biliary drainage. CONCLUSIONS: We suggest that a combination technique using Y and Zilver stents improves bilateral stenting for patients with advanced hilar cholangiocarcinoma and facilitates stent reinsertion in cases of tumor recurrence.
