Korean J Radiol.  2012 Feb;13(Suppl 1):S62-S66. 10.3348/kjr.2012.13.S1.S62.

Recent Advances of Biliary Stent Management

• Kida M
• Miyazawa S
• Iwai T
• Ikeda H
• Takezawa M
• Kikuchi H
• Watanabe M
• Imaizumi H
• Koizumi W

• KMID: 1372869
• DOI: http://doi.org/10.3348/kjr.2012.13.S1.S62

Abstract

Recent progress in chemotherapy has prolonged the survival of patients with malignant biliary strictures, leading to increased rates of stent occlusion. Even we employed metallic stents which contributed to higher rates and longer durations of patency, and occlusion of covered metallic stents now occurs in about half of all patients during their survival. We investigated the complication and patency rate for the removal of covered metallic stents, and found that the durations were similar for initial stent placement and re-intervention. In order to preserve patient quality of life, we currently recommend the use of covered metallic stents for patients with malignant biliary obstruction because of their removability and longest patency duration, even though uncovered metallic stents have similar patency durations.

Keyword

Metallic stent; Stent obstruction; Re-intervention; Biliary stricture; Stent patency

MeSH Terms

Biliary Tract Diseases/*surgery
Coated Materials, Biocompatible
Device Removal
Drainage/methods
Endoscopy
Foreign-Body Migration/surgery
Humans
Metals
Postoperative Complications/surgery
*Stents/adverse effects

Figure

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  Fig. 1 Distal end of Covered SEMS was caught by snare and removed through duodenal endoscope channel.

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  Fig. 2 Kaplan-meier curves comparing cumulative patency of first and second metallic stents in all 186 cases (Endoscopy 2011;43:1039-1044). MPT = median patency time

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  Fig. 3 Kaplan-meier curves comparing cumulative patency of first and second metallic stents in same patients out of 186 patients (Endoscopy 2011;43:1039-1044). MPT = median patency time

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