Simultaneous Side-by-Side Bilateral Placement of Braided-Type Metal Stents Using a 5.9F Delivery System for Unresectable Malignant Hilar Biliary Obstruction: A Preliminary Feasibility Study

• Published in: Journal of investigative surgery Vol. 35; no. 2; pp. 243 - 248
• Main Authors: Cha, Boram, Park, Jin-Seok, Jeong, Seok, Lee, Don Haeng, Cho, Jae Hee
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01-02-2022; Taylor & Francis Group
• Subjects: Bile Duct Neoplasms - complications; Bile Duct Neoplasms - surgery; cholangiocarcinoma; Cholangiopancreatography; Cholestasis - etiology; Cholestasis - surgery; endoscopic retrograde; Feasibility Studies; Humans; malignant hilar bile duct obstruction; Prospective Studies; Retrospective Studies; self expandable metallic stents; side-by-side; Stents - adverse effects; Treatment Outcome; Cholangiopancreatography; endoscopic retrograde; self expandable metallic stents; side-by-side; cholangiocarcinoma; malignant hilar bile duct obstruction
• ISSN: 0894-1939; 1521-0553
• DOI: 10.1080/08941939.2020.1839148

Introduction
Side-by-side (SBS) bilateral placement of self-expandable metal stents (SEMSs) is limited by technical difficulties in cases of malignant hilar bile duct obstruction (MHBO). Recently, a braided SEMS with a 5.9 F ultra-thin introducer was developed that enables simultaneous bilateral stenting.
Materials and Methods
This preliminary study was undertaken to determine the feasibility, safety, and effectiveness of SBS simultaneous bilateral stenting using braided SEMSs and a 5.9 F introducer for MHBO management. We reviewed 8 patients of medical reports who were performed simultaneous SBS placement of SEMSs due to MHBO between January 2016 and January 2018.
Results
Both of technical and clinical success rates were 100% (8/8), and success rate of stent distal end alignment was also 100%. None of early procedure-related adverse events were detected in 30 days after the stent insertion. Median duration of stent patency was 300 days (95% Cl, 280-726.9), and median survival was 229 days (range, 128-728).
Conclusions
: Simultaneous SBS stent placement using novel braided metal stents was found to be feasible in patients with MHBO. Prospective well-designed clinical studies are needed to certify the efficacy of the stenting technique for MHBO.