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Percutaneous insertion of long-covered biliary stents in patients with malignant duodenobiliary stricture

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To investigate the technical feasibility, safety, and efficacy of a long-covered biliary stent in patients with malignant duodenobiliary stricture.

Methods

This retrospective study enrolled 57 consecutive patients (34 men, 23 women; mean age, 64 years; range, 32–85 years) who presented with malignant duodenobiliary stricture between February 2019 and November 2020. All patients were treated with a long (18 or 23 cm)-covered biliary stent.

Results

The biliary stent deployment was technically successful in all 57 patients. The overall adverse event rate was 17.5% (10 of 57 patients). Successful internal drainage was achieved in 55 (96.5%) of 57 patients. The median patient survival and stent patency times were 99 days (95% confidence interval [CI], 58–140 days) and 73 days (95% CI, 60–86 days), respectively. Fourteen (25.5%) of the fifty-five patients presented with biliary stent dysfunction due to sludge (n = 11), tumor overgrowth (n = 1), collapse of the long biliary stent by a subsequently inserted additional duodenal stent (n = 1), or rapidly progressed duodenal cancer (n = 1). A univariate Cox proportional hazards model did not reveal any independent predictor of biliary stent patency.

Conclusions

Percutaneous insertion of a subsequent biliary stent was technically feasible after duodenal stent insertion. Percutaneous insertion of a long-covered biliary stent was safe and effective in patients with malignant duodenobiliary stricture.

Clinical relevance statement

In patients with malignant duodenobiliary stricture, percutaneous insertion of a long-covered biliary stent was safe and effective regardless of duodenal stent placement.

Key Points

• Percutaneous insertion of long-covered biliary stents in patients with malignant duodenobiliary stricture is a safe and effective procedure.

• Biliary stent deployment was technically successful in all 57 patients and successful internal drainage was achieved in 55 (96.5%) of 57 patients.

• The median patient survival and stent patency times were 99 days and 73 days, respectively, after placement of a long-covered biliary stent in patients with duodenobiliary stricture.

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Abbreviations

AoV:

Ampulla of Vater

CBD:

Common bile duct

GB:

Gallbladder

HCC:

Hepatocellular carcinoma

PTBD:

Percutaneous transhepatic biliary drainage

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Radiology, Ewha Womans Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea

    Chang Hoon Oh

  2. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea

    Dong Il Gwon, Hee Ho Chu, Gi-Young Ko & Gun Ha Kim

  3. Department of Radiology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea

    Sang Lim Choi

  4. Department of Radiology, Research Institute of Radiological Science, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea

    Sung Won Kim

Authors
  1. Chang Hoon Oh
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  2. Dong Il Gwon
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Corresponding author

Correspondence to Dong Il Gwon.

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Guarantor

The scientific guarantor of this publication is Dong Il Gwon.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Dong Il Gwon (corresponding author) has significant statistical expertise. Chang Hoon Oh did statistical analyses in this study.

Informed consent

Our Institutional Review Board waived the requirement for patient informed consent because of the retrospective and anonymized nature of the study.

Ethical approval

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Asan Medical Center.

Methodology

• retrospective

• observational

• performed at one institution

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Oh, C.H., Gwon, D.I., Chu, H.H. et al. Percutaneous insertion of long-covered biliary stents in patients with malignant duodenobiliary stricture. Eur Radiol 34, 538–547 (2024). https://doi.org/10.1007/s00330-023-10024-4

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  • DOI: https://doi.org/10.1007/s00330-023-10024-4

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