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Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report

Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report

作     者:Makoto Kobayashi 

作者机构:Division of GastroenterologyYokkaichi Municipal Hospital 

出 版 物:《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期:2019年第7卷第11期

页      面:1323-1329页

核心收录:

学科分类:1002[医学-临床医学] 10[医学] 

主  题:Multi-hole self-expandable metallic stent Malignant biliary stricture Benign biliary stricture Hilar biliary obstruction Distal biliary obstruction Endobiliary radiofrequency ablation Case report 

摘      要:BACKGROUND Uncovered stents used for malignant obstructions in the biliary tree, especially in the hilar area, are prone to obstruction by tumor ingrowths. In comparison, however, covered stents may block bile duct branches and are at risk of migration. We have developed a multi-hole self-expandable metallic stent (MHSEMS), with a hole in each cell, to prevent the obstruction of bile duct branches. In addition, the holes may prevent migration due to small ingrowths by reducing the tension of the membrane. CASE SUMMARY MHSEMS were placed in five patients with a malignant obstruction and one with post-endoscopic sphincterotomy bleeding. Each MHSEMS was successfully deployed in all cases. Patients showed no complications. Two cases were reviewed. Case 1: A 74-year-old male presented with jaundice and was diagnosed with a sigmoid colon cancer and giant liver metastases in the right liver lobe. A MHSEMS was placed in the left bile duct. The jaundice improved and peroral cholangioscopy was performed. Case 2: A 90-year-old female was admitted to hospital for jaundice and diagnosed with cholangiocarcinoma. A MHSEMS was placed in the left bile duct but after 8 months the stent became obstructed by tumor ingrowth. We treated the patient by ablation therapy. A silicone cover separated the internal bile duct from the surrounding tissue, protecting the latter from thermal injury during treatment by endobiliary ablation of the reobstruction. CONCLUSION A MHSEMS is a new choice of stent for biliary tract diseases.

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