Application of ultra-fine metal stents to malignant hilar biliary strictures
10.3760/cma.j.cn321463-20210812-00417
- VernacularTitle:超细金属支架在肝门胆管恶性狭窄中的应用
- Author:
Daojian GAO
1
;
Ling XING
;
Xin YE
;
Jun WU
;
Tiantian WANG
;
Mingxing XIA
;
Bing HU
Author Information
1. 海军军医大学附属东方肝胆外科医院消化内科，上海 200438
- Keywords:
Cholangiopancreatography, endoscopic retrograde;
Klatskin tumor;
Stents;
Self-expanding metal stents
- From:
Chinese Journal of Digestive Endoscopy
2022;39(10):820-826
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility, efficacy, and safety of ultra-fine metal stents for malignant hilar biliary strictures (MHBS).Methods:Ultra-fine metal stents were simultaneously placed into the intrahepatic duct of 30 patients with unresectable malignant hilar biliary strictures of Bismuth type Ⅱ or higher (based on imaging or histological and/or cytological findings) by using the stent-by-stent mode from January 2014 to June 2021 at the Department of Gastroenterology, Eastern Hepatobiliary Surgical Hospital. The technical success rate, clinical efficacy and incidence of complications were observed.Results:The technical success rate was 100.0% (30/30), and the clinical success was achieved in 28 patients (93.3%) . The mean procedure time was 55.7±20.7 min and the placement time was 28.3±18.2 min. Early adverse events included mild acute pancreatitis ( n=2) and cholangitis ( n=5). The median stent patency and the median overall survival were 243 days (95% CI: 186.6-299.4 days) and 237 days (95% CI: 149.0- 325.0 days), respectively. The incidence of late cholangitis was 36.7% (11/30). Stent malfunction occurred in 14 of the 30 patients, and 5 of them received endoscopic reintervention. The technical success rate for the reintervention was 4/5 with the mean procedure time of 49.8±6.9 min. Conclusion:Malignant hilar biliary obstruction endoscopic palliation with ultra-fine metal stents using the stent-by-stent mode is safe, feasible and effective.
