Single-session multiple stent deployment using moving cell stent without dilating initial stent mesh to treat malignant hilar biliary obstruction (with videos)
Single-session multiple stent deployment using moving cell stent without dilating initial stent mesh to treat malignant hilar biliary obstruction (with videos)
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DOI：
10.1002/jhbp.688
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发表时间：
2019-11-13
影响因子：
3
通讯作者：
Higuchi, Kazuhide
中科院分区：
文献类型：
--
作者：
Ogura, Takeshi;Takenaka, Mamoru;Higuchi, Kazuhide
背景恶性肝门部胆道梗阻(MHBO)可采用双侧自膨式金属支架(SEMS)或支架内支架(SIS)技术治疗。移动细胞支架(MCS)是一种新型的SEMS。本研究评估了在一次治疗中使用双侧新型无覆盖SEMS插入SIS技术而不扩张第一个支架的网眼治疗MHBO的技术可行性。方法对2018年8月至12月收治的MHBO并发梗阻性黄疸患者进行回顾性分析。技术成功被定义为使用SIS技术将双侧MCS置入两个或更多胆道，而不使用扩张装置。结果本研究分析了23例MHBO患者的临床资料。在23例患者中，22例(95.6%)应用了双侧SIS技术，但没有扩张第一个支架的网眼。1例Bimuth IV型患者多根导丝插入失败，中位手术时间33.6分钟。胆道梗阻复发的时间为230天。所有患者均未出现严重不良反应。结论未覆盖的移动细胞SEMS可能有助于应用SIS技术进行双侧支架置入。
Background Malignant hilar biliary obstruction (MHBO) can be treated with bilateral self-expandable metal stents (SEMS) deployed using side-by-side (SBS) or stent-in-stent (SIS) techniques. Moving cell stents (MCS) are a novel type of SEMS. The present study evaluated the technical feasibility of treating MHBO using bilateral novel uncovered SEMS to insert an SIS technique without dilating the mesh of a first stent within a single session. Method We retrospectively assessed patients who were complicated with obstructive jaundice due to MHBO between August and December 2018. Technical success was defined as the deployment of a bilateral MCS into two or more biliary tracts using SIS technique without a dilation device. Results The present study analyzed data from 23 consecutive patients who were complicated with MHBO. Bilateral SIS technique with MCS was deployed in 22 (95.6%) of the 23 patients without dilating the mesh of the first stent. Multiple guidewire insertion failed in one patient with Bismuth-type IV. The median procedural duration was 33.6 min. Time to recurrent biliary obstruction was 230 days. Severe adverse events were not seen in any patients. Conclusion In conclusion, uncovered moving cell SEMS might facilitate bilateral stent deployment using SIS technique.