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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 소화기인터벤션의학회 International Journal of Gastrointestinal Intervention International Journal of Gastrointestinal Intervention 제7권 제2호
- 발행연도
- 2018.1
- 수록면
- 78 - 84 (7page)
이용수
초록· 키워드
오류제보하기
Biliary drainage is required for the management of unresectable malignant hilar biliary obstruction (UMHBO), and endoscopic transpapillary drainage is the first-line therapy because it is less invasive. Self-expandable metallic stents (SEMSs) are superior to plastic stents because they have longer stent patency and are more cost-effective. Endoscopic bilateral SEMS placement is technically challenging compared to unilateral placement. However, recent developments in devices and techniques have facilitated bilateral SEMS placement. There are two methods for bilateral hilar SEMS placement for UMHBO: side-by-side (SBS) and stent-in-stent (SIS). Sequential SBS was commonly conducted for bilateral hilar SEMS placement. In a new and thinner delivery system that was developed for SEM placement, two SEMSs could be simultaneously inserted and deployed through the working channel. This new bilateral stenting method enabled us to accomplish simultaneous SBS placement, which increased the success rate of SBS. Insertion of the guidewire and delivery of the second SEMS through the mesh of the first SEMS is challenging in SIS. Newly designed or modified SEMSs that are suitable for SIS have been developed to overcome this challenge, and these SEMSs have facilitated SIS. Uncovered SEMS has been commonly used for hilar SEMS placement, but covered SEMS (CSEMS) is another option for hilar SEMS placement, because CSEMS prevents tumor ingrowth and allows for removal of the stent for re-intervention. Therefore, CSEMS can be used for bilateral SEMS placement in SBS. There are many methods and kinds of SEMS available for bilateral SEMS placement. However, due to lack of evidence, there is no consensus on whether SBS or SIS is optimal for bilateral hilar SEMS placement. In this review, we compared various outcomes between SBS and SIS from previous studies, to clarify which method is better for bilateral SEMS placement for UMHBO.
목차
등록된 정보가 없습니다.
참고문헌 (42)
참고문헌 신청
Wagner HJ / 1993 / Plastic endoprostheses versus metal stents in the palliative treatment of malignant hilar biliary obstruction. A prospective and randomized trial / Endoscopy 25:213~218
Perdue DG / 2008 / Plastic versus self-expanding metallic stents for malignant hilar biliary obstruction : a prospective multicenter observational cohort study / J Clin Gastroenterol 42:1040~1046
Sangchan A / 2012 / Efficacy of metal and plastic stents in unresectable complex hilar cholangiocarcinoma : a randomized controlled trial / Gastrointest Endosc 76:93~99
Mukai T / 2013 / Metallic stents are more efficacious than plastic stents in unresectable malignant hilar biliary strictures : a randomized controlled trial / J Hepatobiliary Pancreat Sci 20:214~222
Chang WH / 1998 / Outcome in patients with bifurcation tumors who undergo unilateral versus bilateral hepatic duct drainage / Gastrointest Endosc 47:354~362
Perdue DG / 2008 / Plastic versus self-expanding metallic stents for malignant hilar biliary obstruction : a prospective multicenter observational cohort study / J Clin Gastroenterol 42:1040~1046
Sangchan A / 2012 / Efficacy of metal and plastic stents in unresectable complex hilar cholangiocarcinoma : a randomized controlled trial / Gastrointest Endosc 76:93~99
Mukai T / 2013 / Metallic stents are more efficacious than plastic stents in unresectable malignant hilar biliary strictures : a randomized controlled trial / J Hepatobiliary Pancreat Sci 20:214~222
Chang WH / 1998 / Outcome in patients with bifurcation tumors who undergo unilateral versus bilateral hepatic duct drainage / Gastrointest Endosc 47:354~362
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