title: Covered metallic stent for ischemic hilar biliary stricture.
abstract: Compared with surgery, endoscopic treatment is safe and highly effective for a postoperative hilar benign bile duct stricture (BDS). However, the long-term outcome of conventional placement of a single biliary stent for hilar benign BDS is generally poor. Although the placement of multiple biliary stents is preferred, multiple stenting in a BDS is difficult. Alternatively, single or multiple stent placement above the papilla ('inside stent') or fully-covered self-expandable metallic stents (SEMS) are feasible approaches for benign BDS. Nevertheless, controversy remains regarding whether and how to perform endoscopic biliary drainage for a hilar benign BDS. In patients with hilar benign BDS, endoscopic biliary drainage can be performed by placing conventional plastic stents across the papilla, plastic stents above the papilla or fully-covered SEMS. Individualized treatment should be considered. We report the placement of a fully-covered SEMS for a hilar benign biliary stricture after extended left hepatectomy.
authors.affiliation: Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. hiropon@med.hokudai.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawakami
authors.forename: Masaki
authors.initials: M
authors.lastname: Kuwatani
authors.forename: Kazunori
authors.initials: K
authors.lastname: Eto
authors.forename: Taiki
authors.initials: T
authors.lastname: Kudo
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asaka
mesh_terms: D001653:Bile Ducts, Intrahepatic / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000628:therapy; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000209:etiology / Q000628:therapy; D004108:Dilatation, Pathologic; D004384:Duodenoscopy; D006431:Hemobilia / Q000150:complications; D006498:Hepatectomy; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000628:therapy*; D008100:Liver Abscess / Q000150:complications / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery / Q000628:therapy; D008297:Male; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed
chemical_list: D008670:Metals