Brief Article
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©2011 Baishideng Publishing Group Co. , Limited. All rights reserved.
World J Gastroenterol. Jun 7, 2011; 17(21): 2652-2657
Published online Jun 7, 2011. doi: 10.3748/wjg.v17.i21.2652
Table 1 Characteristics of patients
Total Stent removal Stent trimming No. patients 27 19 81 Sex (male/female) 17/10 13/6 4/41 Mean age, yr, (range) 68.1 (43-91) 66.9 (43-91) 70.9 (54-90) Etiology of biliary strictures Pancreatic carcinoma 17 12 5 Biliary ductal carcinoma 3 2 1 IPMC 1 0 1 Lymph node metastasis2 1 0 1 Chronic pancreatitis 2 2 0 MFP 2 2 0 AIP 1 1 0 Type of SEMS Uncovered Wallstent 2 1 1 Covered SEMS 25 18 7 Covered Wallstent (Partially covered type) 7 4 3 Niti-S Biliary ComVi Stent (Partially covered type) 2 1 1 Niti-S Biliary ComVi Stent (Fully covered type) 14 11 3 Niti-S Biliary Covered Stent with removal suture 2 2 0
Table 2 Outcome of removal of metallic stent
No. of case Disease Type of SEMS Duration of stent placement (d) Outcome Additional procedures 1 Pancreatic ca. Uncovered Wallstent 180 Unsuccess Trimming 2 Pancreatic ca. Niti-S Biliary ComVi Stent (Partially covered type) 114 Unsuccess Trimming 3 Pancreatic ca. Niti-S Biliary ComVi Stent (Fully covered type) 280 Unsuccess Trimming 4 Bile duct ca. Niti-S Biliary ComVi Stent (Fully covered type) 81 Unsuccess Stent in stent 5 Bile duct ca. Niti-S Biliary ComVi Stent (Fully covered type) 219 Success New SEMS 6 Pancreatic ca Niti-S Biliary ComVi Stent (Fully covered type) 232 Success New SEMS 7 Pancreatic ca. Covered Wallstent (Partially covered type) 15 Success New SEMS 8 Pancreatic ca. Covered Wallstent (Partially covered type) 78 Success New SEMS 9 Pancreatic ca. Niti-S Biliary ComVi Stent (Fully covered type) 155 Success New SEMS 10 Pancreatic ca. Niti-S Biliary ComVi Stent (Fully covered type) 32 Success New SEMS 11 Pancreatic ca. Niti-S Biliary ComVi Stent (Fully covered type) 98 Success New SEMS 12 Pancreatic ca. Niti-S Biliary ComVi Stent (Fully covered type) 50 Success New SEMS 13 Pancreatic ca. Niti-S Biliary ComVi Stent (Fully covered type) 157 Success New SEMS 14 Pancreatic ca. Niti-S Biliary ComVi Stent (Fully covered type) 75 Success New SEMS 15 AIP Niti-S Biliary ComVi Stent (Fully covered type) 8 Success None 16 MFP Covered Wallstent (Partially covered type) 100 Success New SEMS 17 MFP Covered Wallstent (Partially covered type) 176 Unsuccess None 18 CP Niti-S Biliary Covered Stent with removal suture 33 Success New SEMS 19 CP Niti-S Biliary Covered Stent with removal suture 77 Success None
Table 3 Outcome of stent trimming
No. of case Disease SEMS Procedural time (min) Additional procedure after trimming 1 Pancreatic ca. Uncovered Wallstent 12 None 2 Pancreatic ca. Niti-S Biliary ComVi Stent 11 Stent in stent 3 Pancreatic ca. Niti-S Biliary ComVi Stent 14 Stent in stent 4 Pancreatic ca. Covered Wallstent 14 None 5 Pancreatic ca. Covered Wallstent 16 None 6 Bile duct ca. Niti-S Biliary ComVi Stent 12 None 7 IPMC Covered Wallstent 12 None 8 Lymph node metastasis1 Niti-S Biliary ComVi Stent 15 None
Table 4 Review of stent removal
Author Total No. of stent/patient Type of SEMS n Disease Mean duration of indwelling stent (range) Success rate (%) Kahaleh et al [7 ] 18/18 Uncovered Wallstent 2 BBS (1-4 mo) 2/2 (100) Uncovered Wallstent 2 MBS (10-11 mo) 2/2 (100) Covered Wallstent 6 BBS 4.7 mo (1-10 mo) 6/6 (100) Covered Wallstent 8 MBS 4.5 mo (1-16 mo) 7/8 (87.5) Familiari et al [8 ] 39/29 Covered Wallstent 12 12/12 (100) Shim-Hanarostent 10 9/10 (90) Uncovered Wallstent 10 MBS (26) 7.5 mo 5/10 (50) Niti-S Biliary Stent 4 BBS (3) (5 d-16 mo) 3/4 (75) Sinus-Superflex Stent 2 0/2 (0) Zilver Stent 1 0/1 (0) Shin et al [9 ] 30/30 Uncovered Wallstent 5 MBS Uncovered SEMSs 0/5 (0) Zilver Stent 3 MBS 121.4 ± 45.4 d 0/3 (0) Covered Wallstent 21 MBS Covered SEMSs 18/21 (85.7) Covered Wallstent 1 BBS 129.7 ± 95.4 d 1/1 (100) Kahaleh et al [15 ] 65/65 Covered Wallstent 65 BBS 4 mo (1-28 mo) 65/65 (100) Present study 19/19 Covered Wallstent 2 MBS 46.5 d (15-78 d) 2/2 (100) Covered Wallstent 2 BBS (100-176 d) 1/2 (50) Uncovered Wallstent 1 MBS 180 d 0/1 (0) Niti-S Biliary ComVi Stent 11 MBS 136 d (32-280 d) 8/11 (72.7) Niti-S Biliary ComVi Stent 1 BBS 8 d 1/1 (100) Niti-S Biliary Covered Stent with removal suture 2 BBS 55 d (33-77 d) 2/2 (100)
Table 5 Review of biliary stent trimming
Auther Total No. of cases SEMS No. of case Setting of APC system Procedural time Success rate Demarquay et al [4 ] 3 Uncovered Wallstent 3 85 W, coag. 0.8 L/min NA 100% (3/3) Vanbiervliet et al [10 ] 24 Uncovered Wallstent 23 70-80 W, coag. 0.8 L/min < 30 min 95.7% (22/23) Covered Wallstent 1 70-80 W, coag. 0.8 L/min < 30 min 0% (0/1) Guda et al [11 ] 2 Uncovered Wallstent 1 80 W, coag. 2.0 L/min NA 100% (1/1) Uncovered Wallstent 1 60 W, coag. 2.0 L/min NA 100% (1/1) Rerknimitr et al [12 ] 2 Covered Wallstent 1 60 W, coag. 0.8 L/min 20 min 100% (1/1) Uncovered Wallstent 1 70 W, coag. 0.8 L/min NA 100% (1/1) Christiaens et al [13 ] 2 Uncovered SEMS (nitinol) 1 60 W, coag. 1.8 L/min NA 100% (1/1) Uncovered SEMS (nitinol) 1 60 W, coag. 1.8 L/min NA 100% (1/1) Present study 8 Covered Wallstent 3 60-80 W, coag. 1.5 L/min < 20 min 100% (3/3) Uncovered Wallstent 1 60-80 W, coag. 1.5 L/min 12 min 100% (1/1) Niti-S Biliary ComVi Stent 4 60-80 W, coag. 1.5 L/min < 20 min 100% (4/4)
Citation: Ishii K, Itoi T, Sofuni A, Itokawa F, Tsuchiya T, Kurihara T, Tsuji S, Ikeuchi N, Umeda J, Moriyasu F, Tsuchida A. Endoscopic removal and trimming of distal self-expandable metallic biliary stents. World J Gastroenterol 2011; 17(21): 2652-2657
URL: https://www.wjgnet.com/1007-9327/full/v17/i21/2652.htm
DOI: https://dx.doi.org/10.3748/wjg.v17.i21.2652