Simultaneous Side-by-Side Bilateral Placement of Braided-Type Metal Stents Using a 5.9F Delivery System for Unresectable Malignant Hilar Biliary Obstruction: A Preliminary Feasibility Study

Abstract

Introduction

Side-by-side (SBS) bilateral placement of self-expandable metal stents (SEMSs) is limited by technical difficulties in cases of malignant hilar bile duct obstruction (MHBO). Recently, a braided SEMS with a 5.9 F ultra-thin introducer was developed that enables simultaneous bilateral stenting.

Materials and Methods

This preliminary study was undertaken to determine the feasibility, safety, and effectiveness of SBS simultaneous bilateral stenting using braided SEMSs and a 5.9 F introducer for MHBO management. We reviewed 8 patients of medical reports who were performed simultaneous SBS placement of SEMSs due to MHBO between January 2016 and January 2018.

Results

Both of technical and clinical success rates were 100% (8/8), and success rate of stent distal end alignment was also 100%. None of early procedure-related adverse events were detected in 30 days after the stent insertion. Median duration of stent patency was 300 days (95% Cl, 280-726.9), and median survival was 229 days (range, 128-728).

Conclusions: Simultaneous SBS stent placement using novel braided metal stents was found to be feasible in patients with MHBO. Prospective well-designed clinical studies are needed to certify the efficacy of the stenting technique for MHBO.

KEYWORDS:

• Cholangiopancreatography
• endoscopic retrograde
• self expandable metallic stents
• side-by-side
• cholangiocarcinoma
• malignant hilar bile duct obstruction

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Boram Cha, MD: Conception and design, Collection and assembly of data, Analysis and interpretation of the data, Drafting of the article.

Jin-Seok Park, MD: Collection and assembly of data, Analysis and interpretation of the data, Drafting of the article.

Seok Jeong, MD: Conception and design, Collection and assembly of data, Analysis and interpretation of the data, Provision of study materials or patients, Administrative, technical, and logistic support, Critical revision of the article for important intellectual content, Final approval of the article.

Don Haeng Lee, MD: Conception and design, Provision of study materials or patients.

Jae Hee Cho, MD: Administrative, technical, and logistic support, Provision of study materials or patients.

Additional information

Funding

This work was supported by an INHA UNIVERSITY HOSPITAL Research Grant.