title: Endoscopic bilateral metal stent placement for advanced hilar cholangiocarcinoma: a pilot study of a newly designed Y stent.
abstract: BACKGROUND
  Although endoscopic stent placement is now generally accepted as a palliative method of treatment in unresectable hilar cholangiocarcinoma, exclusively endoscopic placement of bilateral metal stents has been considered very difficult and complex.
  
  
  OBJECTIVE
  To evaluate the technical and clinical efficacy of endoscopic placement of dual, newly designed stents in a Y configuration.
  
  
  METHODS
  Prospective, uncontrolled, single center.
  
  
  METHODS
  Tertiary referral university hospital.
  
  
  METHODS
  Ten patients with unresectable hilar cholangiocarcinoma of Bismuth type II or higher.
  
  
  METHODS
  For bilateral metal stent placement, a biliary Y stent with central wide-open mesh was used exclusively at first. A second stent was placed into the contralateral hepatic duct through the central open mesh of the Y stent.
  
  
  METHODS
  Technical success, functional success, early complications, and short-term clinical outcome.
  
  
  RESULTS
  Technical success was achieved in 8 of 10 patients (80%). Among 8 patients in whom bilateral stents were successfully placed by endoscopy, functional success was 100%, the early complication rate was 0%, and the stent occlusion rate was 25%. The median stent patency period was 217 days.
  
  
  CONCLUSIONS
  Small number of patients, uncontrolled study, short-term follow-up period.
  
  
  CONCLUSIONS
  We described a technique for endoscopic bilateral metal stent placement by using the newly designed Y stent for advanced hilar cholangiocarcinoma that resulted in a high success rate of 80%.
authors.affiliation: Department of Internal Medicine, Pusan National University College of Medicine, Seo-Gu, Busan, Korea.
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Dae Hwan
authors.initials: DH
authors.lastname: Kang
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Lee
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Kim
authors.forename: Chan Won
authors.initials: CW
authors.lastname: Park
authors.forename: Hwal Suk
authors.initials: HS
authors.lastname: Cho
authors.forename: Gwang Ha
authors.initials: GH
authors.lastname: Kim
authors.forename: Tae Oh
authors.initials: TO
authors.lastname: Kim
authors.forename: Jeong
authors.initials: J
authors.lastname: Heo
authors.forename: Geun Am
authors.initials: GA
authors.lastname: Song
authors.forename: Mong
authors.initials: M
authors.lastname: Cho
authors.forename: Suk
authors.initials: S
authors.lastname: Kim
authors.forename: Chang Won
authors.initials: CW
authors.lastname: Kim
authors.forename: Jun Woo
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000368:Aged; D000497:Alloys; D001650:Bile Duct Neoplasms / Q000150:complications* / Q000628:therapy; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000150:complications* / Q000628:therapy; D002779:Cholestasis / Q000209:etiology / Q000628:therapy*; D004322:Drainage; D016145:Endoscopy, Digestive System; D005260:Female; D006500:Hepatic Duct, Common; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D015607:Stents
chemical_list: D000497:Alloys; C013616:nitinol