title: One-step placement of a fully-covered metal stent in endosonography-guided biliary drainage for malignant biliary obstruction.
abstract: BACKGROUND
  Although reports on endosonography-guided biliary drainage (ESBD) have been increasing, only a few discuss deployment of a self-expandable metal stent (SEMS) in the first session.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of ESBD with the one-step placement of a newly designed fully-covered SEMS.
  
  
  METHODS
  Five patients with malignant biliary obstruction in whom one-step placement of an anti-migration designed SEMS in the first session of ESBD had been attempted between January 2007 and October 2009 were included in this study. Main outcome measurements were technical and clinical successes, early complications, and short-term results.
  
  
  RESULTS
  ESBD was attempted to bridge the extrahepatic bile duct and the duodenum and one-step SEMS placement was successful in all cases. There were no early complications related to ESBD and excellent biliary decompression was obtained in all cases. SEMS dysfunction such as stent migration and occlusion was not seen during the follow-up period (mean follow-up 138 days, range 102-184 days).
  
  
  CONCLUSIONS
  One-step placement of a fully-covered SEMS in ESBD is possibly a safe and effective treatment for biliary obstruction.
authors.affiliation: Department of Gastroenterology, Sendai City Medical Center, Japan. j-hora@qg7.so-net.ne.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Horaguchi
authors.forename: Naotaka
authors.initials: N
authors.lastname: Fujita
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Noda
authors.forename: Go
authors.initials: G
authors.lastname: Kobayashi
authors.forename: Kei
authors.initials: K
authors.lastname: Ito
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Koshita
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Kanno
authors.forename: Takahisa
authors.initials: T
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater; D001662:Biliary Tract Surgical Procedures / Q000295:instrumentation / Q000379:methods; D001651:Cholestasis, Extrahepatic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000150:complications; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications; D015607:Stents