title: Antireflux metal stent with an antimigration system for distal malignant biliary obstruction: a feasibility pilot study.
abstract: An antireflux metal stent (ARMS) for distal malignant biliary obstruction has been reported to be useful, but the effectiveness of a flared-end structure to prevent migration on ARMS remains unclear. To evaluate the feasibility of a newly designed ARMS with both ends flared, 8 patients with covered metal stent occlusion due to sludge or food impaction were enrolled. ARMS were placed successfully after endoscopic removal of the occluded stents in all patients, and no procedure-related complication was observed. The median time to recurrent biliary obstruction was 71 days. ARMS occlusion occurred in 3 (38%) patients (sludge in 2 patients and hemobilia in 1). ARMS migration occurred in 1 (13%) patient. As a late complication, cholecystitis occurred in 1 (13%) patient. In conclusion, our newly designed ARMS with an antimigration system was technically feasible and safe, and a further investigation is warranted to evaluate the effectiveness of the current antimigration system.
authors: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Tsuyoshi
authors: T
authors: Hamada
authors: Hiroyuki
authors: H
authors: Isayama
authors: Yousuke
authors: Y
authors: Nakai
authors: Osamu
authors: O
authors: Togawa
authors: Hirofumi
authors: H
authors: Kogure
authors: Naminatsu
authors: N
authors: Takahara
authors: Dai
authors: D
authors: Mohri
authors: Takashi
authors: T
authors: Sasaki
authors: Saburo
authors: S
authors: Matsubara
authors: Natsuyo
authors: N
authors: Yamamoto
authors: Kenji
authors: K
authors: Hirano
authors: Minoru
authors: M
authors: Tada
authors: Kazuhiko
authors: K
authors: Koike
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications*; D001655:Bile Reflux / Q000517:prevention & control; D002779:Cholestasis / Q000628:therapy*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D010865:Pilot Projects; D015607:Stents
chemical_list: D008670:Metals