title: Benefits of side-by-side deployment of 6-mm covered self-expandable metal stents for hilar malignant biliary obstructions.
abstract: BACKGROUND
  The best way to perform endoscopic stenting for hilar malignant biliary obstruction (HMBO) is under discussion. Recently, a 6-mm covered self-expandable metal stent (CSEMS) has become available. In this article, the results of side-by-side (SBS) 6-mm CSEMS deployment for HMBO are reported.
  
  
  METHODS
  A total of 22 patients, 32 procedures of SBS 6-mm CSEMS [16 fully covered (FCSEMS), 16 partially covered (PCSEMS)] deployment for HMBO, were prospectively enrolled from November 2011 to June 2015 and retrospectively analyzed. Technical and clinical success rates, stent patency period, complications, and re-intervention success rates were analyzed.
  
  
  RESULTS
  The overall/FCSEMS/PCSEMS technical and clinical success rates were 96.9%/93.8%/100% and 93.5%/100%/87.5%, respectively. The mean stent patency period was 95/113/68 days. Early and late complication rates were 3.1%/0%/6.3% and 6.3%/12.5%/0%, respectively. Stent exchange was attempted in 12 procedures, and the stent exchange success rate was 83.3%/100%/75%.
  
  
  CONCLUSIONS
  This is the first report of SBS 6-mm CSEMS deployment for HMBO. This procedure has high technical and clinical success rates and the advantages of ease of performance and a high success rate of re-intervention. Outcomes appear better with FCSEMS than with PCSEMS deployment. Since stent patency is still controversial, large-sample studies are needed.
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa Ward, Nagoya, Aichi, 464-0021, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa Ward, Nagoya, Aichi, 464-0021, Japan. khara@aichi-cc.jp.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hara
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa Ward, Nagoya, Aichi, 464-0021, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imaoka
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa Ward, Nagoya, Aichi, 464-0021, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Hijioka
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa Ward, Nagoya, Aichi, 464-0021, Japan.
authors.forename: Nobumasa
authors.initials: N
authors.lastname: Mizuno
authors.affiliation: Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ishihara
authors.affiliation: Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tajika
authors.affiliation: Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Niwa
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa Ward, Nagoya, Aichi, 464-0021, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation* / Q000379:methods; D002779:Cholestasis / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D018570:Risk Assessment; D000069322:Self Expandable Metallic Stents / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: Biliary tract neoplasms; Cholangiopancreatography; Endoscopic retrograde; Palliative care; Stents