title: Reintervention for occluded biliary metal stent for patients with malignant distal biliary stricture.
abstract: A metal stent has a longer stent patency than a plastic stent in patients with unresectable malignant distal biliary stricture. However, treatment for stent dysfunction of a metal stent remains unresolved. A review of reported articles regarding reintervention for metal stent dysfunction showed that causes of stent dysfunction included tumor ingrowth/overgrowth, stone/sludge/food impaction, and stent migration. Cleaning of the stent is associated with an early relapse of stent dysfunction. Additional placement of a covered metal stent is expected to have a longer stent patency than that of other stents such as uncovered metal stents or plastic stents. It is recommended that occluded covered metal stents be removed if possible. Stent trimming with argon plasma coagulation is sometimes useful for the treatment of stent displacement. No strategy for occluded metal stents has been established yet. Further clinical trials regarding proper treatments are necessary.
authors.affiliation: Department of Gastroenterology, Sendai City Medical Center, Sendai, Japan. keiito@openhp.or.jp
authors.forename: Kei
authors.initials: K
authors.lastname: Ito
authors.forename: Takahisa
authors.initials: T
authors.lastname: Ogawa
authors.forename: Jun
authors.initials: J
authors.lastname: Horaguchi
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Koshita
authors.forename: Naotaka
authors.initials: N
authors.lastname: Fujita
mesh_terms: D001650:Bile Duct Neoplasms / Q000150:complications / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D006801:Humans; D011183:Postoperative Complications; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods*; D015607:Stents