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Clinical advantages of a metal stent with an S-shaped anti-reflux valve in malignant biliary obstruction

Authors
 Kyong Joo Lee  ;  Moon Jae Chung  ;  Jeong Youp Park  ;  Don Haeng Lee  ;  Suk Jung  ;  Byoung Wook Bang  ;  Seung Woo Park  ;  Jae Bock Chung  ;  Si Young Song  ;  Seungmin Bang 
Citation
 DIGESTIVE ENDOSCOPY, Vol.25(3) : 308-312, 2013 
Journal Title
 DIGESTIVE ENDOSCOPY 
ISSN
 0915-5635 
Issue Date
2013
MeSH
Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms/complications ; Cholestasis/etiology* ; Cholestasis/surgery* ; Endoscopy, Digestive System* ; Equipment Design ; Female ; Gallbladder Neoplasms/complications ; Humans ; Male ; Metals ; Middle Aged ; Pancreatic Neoplasms/complications ; Prostatic Neoplasms/complications ; Republic of Korea ; Stents* ; Stomach Neoplasms/complications
Keywords
anti-reflux valve ; duodenobiliary reflux ; malignantbiliary obstruction ; metal stent
Abstract
BACKGROUND AND AIM: Transpapillary stent insertion is the standard treatment for palliating malignant biliary obstruction. However, luminal occlusion often occurs due to sludge formation, tumor ingrowth, or tumor overgrowth. Currently, influx of duodenal contents by duodenobiliary reflux is considered a mechanism of stent obstruction. The aim of the present study was to evaluate the efficacy and safety of a metal stent with an anti-reflux valve in distal malignant biliary obstruction. METHODS: Thirty-two patients diagnosed with unresectable malignant biliary obstruction were enrolled. This trial was conducted at two tertiary hospitals in Korea from June 2009 to June 2011. An uncovered metal stent (M.I.Tech) with an S-type anti-reflux valve was placed. RESULTS: A total of 32 patients were enrolled. The technical success rate of stent insertion was 100%. The median duration of stent patency was 14.4 months. Stent occlusion occurred in 11 cases, which was caused by sludge formation in six cases, tumor ingrowth in four cases, and migration of the stent membrane in one case. During the follow-up period, there were no episodes of ascending cholangitis, acute pancreatitis, or bleeding. CONCLUSIONS: The new metal stent with an S-shaped anti-reflux valve demonstrated a relatively long duration of stent patency. This was attributable to reductions in duodenobiliary reflux by the anti-reflux valve. Also, the stent with an S-shaped anti-reflux valve is technically feasible and very safe. However, further prospective, randomized comparison studies of stents with anti-reflux valves and conventional stents are needed to evaluate the duration of stent patency.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1443-1661.2012.01382.x/abstract
DOI
10.1111/j.1443-1661.2012.01382.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Chung, Moon Jae(정문재) ORCID logo https://orcid.org/0000-0002-5920-8549
Chung, Jae Bock(정재복)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86753
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