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Digestive Diseases and Sciences

, Volume 62, Issue 1, pp 253–263 | Cite as

Placement of a Newly Designed Y-Configured Bilateral Self-Expanding Metallic Stent for Hilar Biliary Obstruction: A Pilot Study

  • Dechao Jiao
  • Kai Huang
  • Ming Zhu
  • Gang Wu
  • Jianzhuang Ren
  • Yanli Wang
  • Xinwei HanEmail author
Original Article

Abstract

Background

Whether unilateral or bilateral drainage should be performed for malignant hilar biliary obstruction remains a matter of debate. Although a Y-stent with a central wide-open mesh facilitates bilateral stent placement, it has its own limitations.

Aim

This study aims to evaluate the feasibility and efficacy of a newly designed Y-configured bilateral self-expanding metallic stent (SEMS) for the treatment of hilar biliary obstruction.

Methods

In this retrospective study, 14 consecutive patients with unresectable malignant hilar biliary obstruction (Bismuth type II or higher), who underwent placement of a newly designed Y-configured bilateral SEMS for hilar biliary obstruction from April 2013 to March 2015, were included into this study. Data on technical success, clinical success, stent patency, complications and patient survival were collected.

Results

Technical and clinical success was 100 and 92.9 %, respectively. Mean serum bilirubin level was significantly decreased 1 month after stent placement (P < 0.01). Furthermore, two patients (14.3 %) had early complications (one patient had severe hemobilia and one patient had cholangitis), and two patients (14.3 %) had late complications (one patient had cholangitis and one patient had cholecystitis). During the mean follow-up period of 298 days (range 89–465 days), six patients (42.9 %) developed stent occlusion caused by tumor ingrowth or overgrowth (n = 5) and sludge (n = 1). Median stent patency and overall survival times were 281 days (95 % CI 175.9–386.1 days) and 381 days (95 % CI 291.4–470.6 days), respectively.

Conclusion

The use of the newly designed Y-configured bilateral SEMS is feasible and effective for hilar biliary obstruction using port docking deployment.

Keywords

Hilar biliary obstruction Stent Klatskin tumor Fluoroscopy 

Notes

Funding

This work was supported by the National High-Tech Research and Development Program (863 Program) (Grant Number: 2015AA020301).

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest with this work.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Dechao Jiao
    • 1
  • Kai Huang
    • 2
  • Ming Zhu
    • 1
  • Gang Wu
    • 1
  • Jianzhuang Ren
    • 1
  • Yanli Wang
    • 1
  • Xinwei Han
    • 1
    Email author
  1. 1.Department of Interventional RadiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouPeople’s Republic of China
  2. 2.Department of OncologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouPeople’s Republic of China

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