Stenting and interventional radiology for obstructive jaundice in patients with unresectable biliary tract carcinomas.
Together with biliary drainage, which is an appropriate procedure for unresectable biliary cancer, biliary stent placement is used to improve symptoms associated with jaundice. Owing to investigations comparing percutaneous transhepatic biliary drainage (PTBD), surgical drainage, and endoscopic drainage, many types of stents are now available that can be placed endoscopically. The stents used are classified roughly as plastic stents and metal stents. Compared with plastic stents, metal stents are of large diameter, and have long-term patency (although they are expensive). For this reason, the use of metal stents is preferred for patients who are expected to survive for more than 6 months, whereas for patients who are likely to survive for less than 6 months, the use of plastic stents is not considered to be improper. Obstruction in a metal stent is caused by a tumor that grows within the stent through the mesh interstices. To overcome such problems, a covered metal stent was developed, and these stents are now used in patients with malignant distal biliary obstruction. However, this type of stent has been reported to have several shortcomings, such as being associated with the development of acute cholecystitis and stent migration. In spite of these shortcomings, evidence is expected to demonstrate its superiority over other types of stent.
Tsuyuguchi
Toshio
T
Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, Chiba, Japan.
Takada
Tadahiro
T
Miyazaki
Masaru
M
Miyakawa
Shuichi
S
Tsukada
Kazuhiro
K
Nagino
Masato
M
Kondo
Satoshi
S
Furuse
Junji
J
Saito
Hiroya
H
Suyama
Masafumi
M
Kimura
Fumio
F
Yoshitomi
Hideyuki
H
Nozawa
Satoshi
S
Yoshida
Masahiro
M
Wada
Keita
K
Amano
Hodaka
H
Miura
Fumihiko
F
D014670:Ampulla of Vater / Q000000981:diagnostic imaging / Q000601:surgery; D001661:Biliary Tract Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D004867:Equipment Design; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D015642:Radiology, Interventional; D016032:Randomized Controlled Trials as Topic; D015607:Stents / Q000009:adverse effects / Q000145:classification