Published online Jan 16, 2018. doi: 10.4253/wjge.v10.i1.16
Peer-review started: July 6, 2017
First decision: August 7, 2017
Revised: August 30, 2017
Accepted: November 3, 2017
Article in press: November 3, 2017
Published online: January 16, 2018
To investigate whether an uncovered self-expandable metal stent (UCSEMS) with a large diameter could prevent recurrent biliary obstruction (RBO).
Thirty-eight patients with malignant biliary obstruction underwent treatment with an UCSEMS with a 14-mm diameter (Niti-S 14). Retrospectively, we evaluated technical and functional success rate, RBO rate, time to RBO, survival time, and adverse events in these patients.
Stent placement success and functional success were achieved in all patients. Two patients (5.3%) had RBO due to tumor ingrowth or overgrowth. The median time to RBO was 190 (range, 164-215) d. The median survival time was 120 (range, 18-502) d. The 6-mo non-RBO rate was 91%. Other adverse events other than RBO occurred as follows: Acute cholecystitis, post-ERCP pancreatitis, hemobilia, and fever without exacerbation of liver injury, and liver abscess in 4 (10.3%), 3 (7.9%), 2 (5.3%), 1 (2.6%), and 1 (2.6%), respectively. Migration of the stents was not observed.
Niti-S 14 is considered to be a preferable metal stent because of a low rate of RBO with no migration.
Core tip: Our manuscript reports on 38 patients with unresectable distal malignant biliary obstruction (MBO) treated with a newly developed 14-mm diameter Niti-S biliary uncovered metal stent. The results could show the stent is preferable for the palliate treatment of unresectable distal MBO because of a low rate of recurrent biliary obstruction, no migration, a low rate of other complications, and a high success rate of placement.