title: TOKYO criteria 2014 for transpapillary biliary stenting.
abstract: It is difficult to carry out meta-analyses or to compare the results of different studies of biliary stents because there is no uniform evaluation method. Therefore, a standardized reporting system is required. We propose a new standardized system for reporting on biliary stents, the 'TOKYO criteria 2014', based on a consensus among Japanese pancreatobiliary endoscopists. Instead of stent occlusion, we use recurrent biliary obstruction, which includes occlusion and migration. The time to recurrent biliary obstruction was estimated using Kaplan-Meier analysis with the log-rank test. We can evaluate both plastic and self-expandable metallic stents (uncovered and covered). We also propose specification of the cause of recurrent biliary obstruction, identification of complications other than recurrent biliary obstruction, indication of severity, measures of technical and clinical success, and a standard for clinical care. Most importantly, the TOKYO criteria 2014 allow comparison of biliary stent quality across studies. Because blocked stents can be drained not only using transpapillary techniques but also by an endoscopic ultrasonography-guided transmural procedure, we should devise an evaluation method that includes transmural stenting in the near future.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hamada
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yasuda
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Shomei
authors.initials: S
authors.lastname: Ryozawa
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Nakai
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kogure
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D002779:Cholestasis / Q000601:surgery*; D006801:Humans; D017410:Practice Guidelines as Topic; D019919:Prosthesis Implantation / Q000592:standards*; D015607:Stents; D014041:Tokyo
keywords: biliary drainage; biliary stent; biliary stricture; metallic stent; obstructive jaundice