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Newly designed plastic stent for endoscopic placement above the sphincter of O ddi in patients with malignant hilar biliary obstruction
Author(s) -
Ishiwatari Hirotoshi,
Hayashi Tsuyoshi,
Ono Michihiro,
Sato Tsutomu,
Kato Junji
Publication year - 2013
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12080
Subject(s) - medicine , stent , sphincter of oddi , surgery , occlusion , radiology , stenosis
Background Plastic stent ( PS ) occlusion occurs as a result of bacterial adherence to the stent's inner wall. To retain the bacteriological barrier, placing a PS above the sphincter of O ddi (‘inside stent’) has been investigated. We designed a new PS (inside stent with thread [ IT ] stent) with attachable nylon thread for use as an inside stent and for easy retrieval. The present study evaluated the IT stent's technical feasibility and efficacy for malignant hilar biliary obstruction. Patients and Methods A total of 26 consecutive patients with unresectable malignant hilar biliary obstruction underwent placement of IT stents from A ugust 2007 to F ebruary 2011. IT stents were placed across the strictures without sphincterotomy to achieve bilateral drainage. Results The overall technical success rate of the IT stent was 100% for one session. Multiple IT stents were inserted in 25 cases(two stents in 15 patients, three stents in 10 patients). No stent‐related early complications occurred. The functional success rate was 92% (24/26). The rate of reintervention because of stent malfunction was 50% (13/26). In all 16 patients who underwent stent removal, IT stents were easily retrieved using the nylon thread. According to K aplan– M eier analysis, the median stent patency period was 136 days. Conclusion IT stents for endoscopic placement above the sphincter of O ddi can be used safely and effectively for malignant hilar biliary obstruction.