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Newly developed fully covered metal stent for unresectable malignant biliary stricture.

Ito K, Fujita N, Noda Y, Kobayashi G, Obana T, Horaguchi J, Koshita S, Kanno Y, Ogawa T, Kato Y, Yamashita Y - Diagn Ther Endosc (2010)

Bottom Line: In the second case of middle bile duct stricture due to lymph node metastases from gallbladder cancer, a stent was placed in the bile duct across the stenosis.No procedure-related complications were observed.Unevenness of the outer surface and a low shortening ratio are expected to lessen the occurrence of complications characteristic of covered metal stents such as stent migration and bile duct kinking.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai, Miyagi 983-0824, Japan.

ABSTRACT
We herein report two patients with unresectable malignant biliary stricture who underwent stenting with a newly developed fully-covered metal stent. In the first case of lower-middle bile duct cancer, a stent was placed through the stenosis. In the second case of middle bile duct stricture due to lymph node metastases from gallbladder cancer, a stent was placed in the bile duct across the stenosis. No procedure-related complications were observed. Unevenness of the outer surface and a low shortening ratio are expected to lessen the occurrence of complications characteristic of covered metal stents such as stent migration and bile duct kinking.

No MeSH data available.


Related in: MedlinePlus

(a, b) Endoscopic retrograde cholangiography; (c) duodenoscopy; (d) fluoroscopy. ERC revealed strictures (arrows), 4 cm in length, in the lower-middle bile duct (a). A fully-covered metal stent (arrows) (covered Zeostent), 8 cm in length and 1 cm in diameter, was placed through the papilla of Vater and the stricture (b, c). The stent was fully expanded the day after the procedure (d).
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fig1: (a, b) Endoscopic retrograde cholangiography; (c) duodenoscopy; (d) fluoroscopy. ERC revealed strictures (arrows), 4 cm in length, in the lower-middle bile duct (a). A fully-covered metal stent (arrows) (covered Zeostent), 8 cm in length and 1 cm in diameter, was placed through the papilla of Vater and the stricture (b, c). The stent was fully expanded the day after the procedure (d).

Mentions: Endoscopic retrograde cholangiography (ERC) revealed a strictures, 5 cm in length, in the lower-middle bile duct (Figure 1(a)). Transpapillary intraductal ultrasonography of the bile duct revealed a tumor, spreading from the lower bile duct to the upper bile duct. Based on the diagnosis of widespread bile duct cancer, an 8 Fr plastic stent was placed through the biliary stricture up to the upper bile duct for biliary decompression following sphincterotomy. Ten days after the procedure, replacement of the plastic stent with a covered metal stent was attempted as a palliative therapy after obtaining informed consent. Using a duodenoscope (TJF-260 V: Olympus Medical Systems, Co., Ltd. Tokyo, Japan), a fully-covered metal stent (covered Zeostent: Zeon Medical Inc., Tokyo, Japan) (Figure 2), 8 cm in length and 1 cm in diameter, was placed through the stricture (Figures 1(b) and 1(c)). There were no clinical symptoms suggesting development of pancreatitis. The placed stent was fully expanded the day after the procedure (Figure 1(d)). After improvement of jaundice, the patient received chemotherapy. No complications such as stent migration and occlusion were observed during the five-month followup period.


Newly developed fully covered metal stent for unresectable malignant biliary stricture.

Ito K, Fujita N, Noda Y, Kobayashi G, Obana T, Horaguchi J, Koshita S, Kanno Y, Ogawa T, Kato Y, Yamashita Y - Diagn Ther Endosc (2010)

(a, b) Endoscopic retrograde cholangiography; (c) duodenoscopy; (d) fluoroscopy. ERC revealed strictures (arrows), 4 cm in length, in the lower-middle bile duct (a). A fully-covered metal stent (arrows) (covered Zeostent), 8 cm in length and 1 cm in diameter, was placed through the papilla of Vater and the stricture (b, c). The stent was fully expanded the day after the procedure (d).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2963128&req=5

fig1: (a, b) Endoscopic retrograde cholangiography; (c) duodenoscopy; (d) fluoroscopy. ERC revealed strictures (arrows), 4 cm in length, in the lower-middle bile duct (a). A fully-covered metal stent (arrows) (covered Zeostent), 8 cm in length and 1 cm in diameter, was placed through the papilla of Vater and the stricture (b, c). The stent was fully expanded the day after the procedure (d).
Mentions: Endoscopic retrograde cholangiography (ERC) revealed a strictures, 5 cm in length, in the lower-middle bile duct (Figure 1(a)). Transpapillary intraductal ultrasonography of the bile duct revealed a tumor, spreading from the lower bile duct to the upper bile duct. Based on the diagnosis of widespread bile duct cancer, an 8 Fr plastic stent was placed through the biliary stricture up to the upper bile duct for biliary decompression following sphincterotomy. Ten days after the procedure, replacement of the plastic stent with a covered metal stent was attempted as a palliative therapy after obtaining informed consent. Using a duodenoscope (TJF-260 V: Olympus Medical Systems, Co., Ltd. Tokyo, Japan), a fully-covered metal stent (covered Zeostent: Zeon Medical Inc., Tokyo, Japan) (Figure 2), 8 cm in length and 1 cm in diameter, was placed through the stricture (Figures 1(b) and 1(c)). There were no clinical symptoms suggesting development of pancreatitis. The placed stent was fully expanded the day after the procedure (Figure 1(d)). After improvement of jaundice, the patient received chemotherapy. No complications such as stent migration and occlusion were observed during the five-month followup period.

Bottom Line: In the second case of middle bile duct stricture due to lymph node metastases from gallbladder cancer, a stent was placed in the bile duct across the stenosis.No procedure-related complications were observed.Unevenness of the outer surface and a low shortening ratio are expected to lessen the occurrence of complications characteristic of covered metal stents such as stent migration and bile duct kinking.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai, Miyagi 983-0824, Japan.

ABSTRACT
We herein report two patients with unresectable malignant biliary stricture who underwent stenting with a newly developed fully-covered metal stent. In the first case of lower-middle bile duct cancer, a stent was placed through the stenosis. In the second case of middle bile duct stricture due to lymph node metastases from gallbladder cancer, a stent was placed in the bile duct across the stenosis. No procedure-related complications were observed. Unevenness of the outer surface and a low shortening ratio are expected to lessen the occurrence of complications characteristic of covered metal stents such as stent migration and bile duct kinking.

No MeSH data available.


Related in: MedlinePlus