Endoscopic bilateral metal stent placement for advanced hilar cholangiocarcinoma: a pilot study of a newly designed Y stent.
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%.
Lee
Jung Hyun
JH
Department of Internal Medicine, Pusan National University College of Medicine, Seo-Gu, Busan, Korea.
Kang
Dae Hwan
DH
Kim
Ji Young
JY
Lee
Sun Mi
SM
Kim
Do Hoon
DH
Park
Chan Won
CW
Cho
Hwal Suk
HS
Kim
Gwang Ha
GH
Kim
Tae Oh
TO
Heo
Jeong
J
Song
Geun Am
GA
Cho
Mong
M
Kim
Suk
S
Kim
Chang Won
CW
Lee
Jun Woo
JW
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
D000497:Alloys; C013616:nitinol