Int J Gastrointest Interv.  2019 Apr;8(2):82-86. 10.18528/ijgii180045.

Histopathological examination following side-by-side placement of metal stents for malignant hilar biliary obstruction

• Nakagawara H
• Yamao K
• Gotoda T
• Kikuta D
• Takei A
• Iwatsuka K
• Takahashi
• Ogawa M
• Henmi A
• Kobayashi
• Moriyama M

• KMID: 2448934
• DOI: http://doi.org/10.18528/ijgii180045

Abstract

BACKGROUND
Endoscopic-guided placement of metal stents for unresectable malignant hilar biliary obstruction (UMHBO) is performed using partial stent-in-stent or side-by-side (SBS) techniques. The latter involves placing sequential stents within the bile duct. Excessive dilation of the bile duct during stent placement can have serious effects on the surrounding organs.
METHODS
This study details seven cases of SBS placement of 8.0 mm metal stents for UMHBO. Histopathological examinations were performed to identify the effects on the bile duct and surrounding tissues.
RESULTS
The mean post-placement diameter of the bile ducts was 13.86 mm, and no compression necrosis or thrombi were observed in surrounding tissues. Cholangitis occurred in five cases, and death occurred as a result of cholecystitis in one case.
CONCLUSION
The use of 8.0-mm stents for SBS is unlikely to have major negative effects on peribiliary tissues and blood vessels. However, postplacement cholecystitis can result in increased mortality; thus, gallbladder drainage should be considered.

Keyword

Autopsy; Bile duct obstruction; Cholangiocarcinoma; Cholangiopancreatography, endoscopic retrograde

MeSH Terms

Autopsy
Bile Ducts
Blood Vessels
Cholangiocarcinoma
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis
Cholecystitis
Cholestasis
Drainage
Gallbladder
Mortality
Necrosis
Stents*