start-ver=1.4
cd-journal=joma
no-vol=60
cd-vols=
no-issue=123
article-no=
start-page=447
end-page=451
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2013
dt-pub=201305
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Management of Occluded Metallic Stents in Malignant Hilar Biliary Stricture
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Background/Aims: Little is known about the management of occluded multiple metallic stent (MS) deployed in malignant hilar biliary strictures (HBS). The purpose of this study was to evaluate the endoscopic management of occluded multiple MSs deployed in HBS. Methodology: Fifty-five patients with unresectable biliary tract carcinoma had multiple MSs inserted due to HBS. The endoscopic intervention through the duodenal papilla was performed on 30 cases that had MS occlusion. The procedure success rate, the survival time after the procedure and the number of endoscopic interventions before death were analyzed, retrospectively. Results: The causes of MS obstruction were tissue ingrowth (n=20), sludge (n=7), tumor overgrowth (n=2), and hemobilia (n=1). Endoscopic cleaning or deployment of plastic stents or metallic stents was performed on these patients and was successfully accomplished only via the transpapillary approach. The survival time after MS obstruction was 219 days. The median number of endoscopic interventions before death was 3. The median interval of endoscopic intervention after the first plastic stent occlusion was 84 days. Conclusions: Our long-term data regarding the endoscopic management of occluded MSs deployed in malignant hilar biliary strictures are acceptable although the patency time of plastic stents deployed after MS occlusion was relatively short.
en-copyright=
kn-copyright=

en-aut-name=FujiiMasakuni
en-aut-sei=Fujii
en-aut-mei=Masakuni
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=

en-aut-name=KawamotoHirofumi
en-aut-sei=Kawamoto
en-aut-mei=Hirofumi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=

en-aut-name=TsutsumiKoichiro
en-aut-sei=Tsutsumi
en-aut-mei=Koichiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=

en-aut-name=KatoHironari
en-aut-sei=Kato
en-aut-mei=Hironari
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=

en-aut-name=HiraoKen
en-aut-sei=Hirao
en-aut-mei=Ken
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=

en-aut-name=KuriharaNaoko
en-aut-sei=Kurihara
en-aut-mei=Naoko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=6
ORCID=

en-aut-name=MizunoOsamu
en-aut-sei=Mizuno
en-aut-mei=Osamu
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=7
ORCID=

en-aut-name=IshidaEtsuji
en-aut-sei=Ishida
en-aut-mei=Etsuji
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=8
ORCID=

en-aut-name=OgawaTsuneyoshi
en-aut-sei=Ogawa
en-aut-mei=Tsuneyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=9
ORCID=

en-aut-name=FukatsuHirotoshi
en-aut-sei=Fukatsu
en-aut-mei=Hirotoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=10
ORCID=

en-aut-name=YamamotoKazuhide
en-aut-sei=Yamamoto
en-aut-mei=Kazuhide
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=11
ORCID=

affil-num=1
en-affil=
kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol

affil-num=2
en-affil=
kn-affil=Kawasaki Med Univ, Dept Gen Internal Med 2

affil-num=3
en-affil=
kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol

affil-num=4
en-affil=
kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol

affil-num=5
en-affil=
kn-affil=Hiroshima City Hosp, Dept Internal Med

affil-num=6
en-affil=
kn-affil=Kurashiki Med Ctr

affil-num=7
en-affil=
kn-affil=Mizuno Med Clin

affil-num=8
en-affil=
kn-affil=Kurashiki Cent Hosp, Dept Gastroenterol

affil-num=9
en-affil=
kn-affil=Hiroshima City Hosp, Dept Internal Med

affil-num=10
en-affil=
kn-affil=Himeji Red Cross Hosp, Dept Internal Med

affil-num=11
en-affil=
kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol
en-keyword=Malignant hilar biliary stricture
kn-keyword=Malignant hilar biliary stricture
en-keyword=Metallic stent
kn-keyword=Metallic stent
en-keyword=Obstruction
kn-keyword=Obstruction
END