Premium
TOKYO criteria 2014 for transpapillary biliary stenting
Author(s) -
Isayama Hiroyuki,
Hamada Tsuyoshi,
Yasuda Ichiro,
Itoi Takao,
Ryozawa Shomei,
Nakai Yousuke,
Kogure Hirofumi,
Koike Kazuhiko
Publication year - 2015
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.12379
Subject(s) - medicine , occlusion , biliary stent , stent , biliary drainage , radiology , endoscopic ultrasonography , surgery , endoscopy
It is difficult to carry out meta‐analyses or to compare the results of different studies of biliary stents because there is no uniform evaluation method. Therefore, a standardized reporting system is required. We propose a new standardized system for reporting on biliary stents, the ‘ TOKYO criteria 2014’, based on a consensus among J apanese pancreatobiliary endoscopists. Instead of stent occlusion, we use recurrent biliary obstruction, which includes occlusion and migration. The time to recurrent biliary obstruction was estimated using K aplan– M eier analysis with the log–rank test. We can evaluate both plastic and self‐expandable metallic stents (uncovered and covered). We also propose specification of the cause of recurrent biliary obstruction, identification of complications other than recurrent biliary obstruction, indication of severity, measures of technical and clinical success, and a standard for clinical care. Most importantly, the TOKYO criteria 2014 allow comparison of biliary stent quality across studies. Because blocked stents can be drained not only using transpapillary techniques but also by an endoscopic ultrasonography‐guided transmural procedure, we should devise an evaluation method that includes transmural stenting in the near future.