Biomaterials Research (생체재료학회지)

Korean Society for Biomaterials (한국생체재료학회)
권호 표지

Stent Placement for Treatment of Biliary Obstruction

담관 협착 치료를 위한 스텐트 삽입술

  • Cho, Young Kwon (Department of Radiology, Eulji University College of Medicine) ;
  • Park, Sangsoo (Department of Biomedical Engineering, Eulji University) ;
  • Gwon, Dong Il (Department of Radiology, Ulsan University College of Medicine) ;
  • Kang, Sung Kwon (Department of Radiology, Seoul Nat'l University College of Medicine)
  • 조영권 (을지대학교 의과대학 영상의학과) ;
  • 박상수 (을지대학교 의료공학과) ;
  • 권동일 (울산대학교 의과대학 영상의학과) ;
  • 강성권 (서울대학교 의과대학 영상의학과)
  • Published : 2012.09.01
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Abstract

Stenting is the most common palliative treatment for patients suffering from either benign or malignant biliary strictures. First introduced in late 1970s, polymeric tube stent has been the most common stent but has had a problem of stent obstruction with sludge within 3-4 months. Self-expandable metallic stent (SEMS), with much larger diameter, considerably prolonged the stent patency period in biliary stenting. SEMS, however, has its own problem of tissue ingrowth through the stent wire mesh and difficulty in repositioning or removal when it is necessary. Polymer-covered self-expandable metallic stent (PC-SEMS) is widening its application scope, as it has both large lumen and protection from tissue ingrowth through the stent wire mesh. PC-SEMS, however, has yet to solve its own problem of dislocation. Various aspects of the three biliary stent types are discussed in this paper.

Keywords

References

  1. M. Kida, S. Miyazawa, T. Iwai, H. Ikeda, M. Takezawa, H. Kikuchi, M. Watanabe, H. Imaizumi, and W. Koizumi, "Recent Advances of Biliary Stent Management," Korean J. Radiol., 13, S62-S66 (2012). https://doi.org/10.3348/kjr.2012.13.S1.S62
  2. F. Li, F. Wang, X. Yang, D. Ji, J. Li, N. Wang, Y. Liu, C. Li, T. Zhang, and K. Li, "Covered stents versus uncovered stents for the palliation of malignant extrahepatic biliary obstruction caused by direct tumor invasion: a cohort comparative study," Med Oncol, (DOI=10.1007/s12032-12012-10187-y) (2012).
  3. G. Costamagna, M. Pandolfi, M. Mutignani, C. Spada, and V. Perri, "Long-term results of endoscopic management of postoperative bile duct strictures with increasing numbers of stents," Gastrointest. Endosc., 54, 162-168 (2001). https://doi.org/10.1067/mge.2001.116876
  4. J. U. Shin and K. T. Lee, "Fully Covered Self Expandable Metal Stent for the Treatment of Benign Biliary Strictures," Korean J. Gastroenterol., 59, 58-60 (2012). https://doi.org/10.4166/kjg.2012.59.1.58
  5. B. H. Lee, D. H. Choe, J. H. Lee, K. H. Kim, and S. Y. Chin, "Metallic stents in malignant biliary obstruction: Prospective long-term clinical results," Am. J. Roentgenol., 168, 741-745 (1997). https://doi.org/10.2214/ajr.168.3.9057527
  6. A. C. Smith, J. F. Dowsett, R. C. G. Russell, A. R. W. Hatfield, and P. B. Cotton, "Randomized Trial of Endoscopic Stenting Versus Surgical Bypass in Malignant Low Bileduct Obstruction," Lancet., 344, 1655-1660 (1994). https://doi.org/10.1016/S0140-6736(94)90455-3
  7. L. Boguth, S. Tatalovic, F. Antonucci, M. Heer, H. Sulser, and C. L. Zollikofer, "Malignant Biliary Obstruction - Clinical and Histopathologic Correlation after Treatment with Self-Expanding Metal Prostheses," Radiology., 192, 669-674 (1994). https://doi.org/10.1148/radiology.192.3.8058931
  8. J. L. K. A. Hausegger; R. Kleinert,; G. E. Klein; F. Fluckiger, "Malignant biliary obstruction: histologic findings after treatment with self-expandable stents," Radiology., 185, 461-464 (1992). https://doi.org/10.1148/radiology.185.2.1410354
  9. J. Stocker and J. S. Lameris, "Complications of percutaneously inserted biliary Wallstents," J. Vasc. Interv. Radiol., 767-772 (1993).
  10. T. H. Baron, "Covered self-expandable metal stents for benign biliary tract diseases," Current Opinion in Gastroenterology., 27, 262-267 (2011). https://doi.org/10.1097/MOG.0b013e3283438a26
  11. J. K. Park, J. H. Moon, H. J. Choi, S. K. Min, T. H. Lee, G. J. Cheon, Y. K. Cheon, Y. D. Cho, S. H. Park, and S. J. Kim, "Anchoring of a Fully Covered Self-Expandable Metal Stent With a 5F Double-Pigtail Plastic Stent to Prevent Migration in the Management of Benign Biliary Strictures," Am. J. Gastroenterol., 106, 1761-1765 (2011). https://doi.org/10.1038/ajg.2011.212
  12. A. Sangchan, W. Kongkasame, A. Pugkhem, K. Jenwitheesuk, and P. Mairiang, "Efficacy of metal and plastic stents in unresectable complex hilar cholangiocarcinoma: a randomized controlled trial," Gastrointest. Endosc., 76, 93-99 (2012). https://doi.org/10.1016/j.gie.2012.02.048
  13. S. Park, T. H. Kim, S. W. Song, S. G. Kang, S. J. Huh, E. S. Kim, C. S. Kim, and H. Y. Song, "Physical Properties of a New Type of Self-expandable Nitinol Stent.," J Kor Radiol Soc., 41(2), 275-280 (1999). https://doi.org/10.3348/jkrs.1999.41.2.275
  14. C. R. Johnston, K. Lee, J. Flewitt, R. Moore, G. M. Dobson, and G. M. Thornton, "The Mechanical Properties of Endovascular Stents: An In Vitro Assessment," Cardiovascular Engineering., 10, 128-135 (2010). https://doi.org/10.1007/s10558-010-9097-9
  15. J. F. Dyet, W. G. Watts, D. F. Ettles, and A. A. Nicholson, "Mechanical properties of metallic stents: How do these properties influence the choice of stent for specific lesions?," Cardiovasc. Intervent. Radiol., 23, 47-54 (2000). https://doi.org/10.1007/s002709910007
  16. G. Donelli, E. Guaglianone, R. D. Rosa, F. Fiocca, and A. Basoli, "Plastic Biliary Stent Occlusion: Factors Involved and Possible Preventive Approaches," Clinical Medicine & Research., 5, 53-60 (2007). https://doi.org/10.3121/cmr.2007.683
  17. Basoli A, Fiocca F, Di Rosa R, Baldassarri L, and D. G., Biliary stent occlusion: a microbiological and scanning electron microscopy (SEM) investigation., in "Advances in abdominal surgery", Zanella E., (Ed.), Kluwer Academic Publishers: Dordrecht, The Netherlands, 1999, pp. 69-80.
  18. A. K. Groen, T. Out, K. Huibregtse, B. Delzenne, F. J. Hoek, and G. N. Tytgat, "Characterization of the content of occluded biliary endoprostheses," Endoscopy., 19, 57-59 (1987). https://doi.org/10.1055/s-2007-1018235
  19. A. G. Speer, P. B. Cotton, J. Rode, A. M. Seddon, C. R. Neal, J. Holton, and J. W. Costerton, "Biliary stent blockage with bacterial biofilm. A light and electron microscopy study," Ann. Intern. Med., 108, 546-553 (1988). https://doi.org/10.7326/0003-4819-108-4-546
  20. J. W. Leung, Y. Liu, R. C. Chan, Y. Tang, Y. Mina, A. F. Cheng, and J. Silva, Jr., "Early attachment of anaerobic bacteria may play an important role in biliary stent blockage," Gastrointest. Endosc., 52, 725-729 (2000). https://doi.org/10.1067/mge.2000.108964
  21. F. Cetta, R. Rappuoli, G. Montalto, C. Baldi, M. Gori, D. Cetta, M. Zuckermann, A. Magnani, and R. Barbucci, "New biliary endoprosthesis less liable to block in biliary infections: Description and in vitro studies," Eur. J. Surg., 165, 782-785 (1999). https://doi.org/10.1080/11024159950189582
  22. B. Jansen, L. P. Goodman, and D. Ruiten, "Bacterial Adherence to Hydrophilic Polymer-Coated Polyurethane Stents," Gastrointest. Endosc., 39, 670-673 (1993). https://doi.org/10.1016/S0016-5107(93)70220-5
  23. J. W. Leung, G. T. Lau, J. J. Sung, and J. W. Costerton, "Decreased bacterial adherence to silver-coated stent material: an in vitro study.," Gastrointest. Endosc., 38, 338-340 (1992). https://doi.org/10.1016/S0016-5107(92)70428-3
  24. E. N. Rees, S. E. Tebbs, and T. S. Elliott, "Role of antimicrobialimpregnated polymer and Teflon in the prevention of biliary stent blockage," J. Hosp. Infect., 39, 323-329 (1998). https://doi.org/10.1016/S0195-6701(98)90298-5
  25. J. Y. Sung, E. A. Shaffer, K. Lam, I. Rususka, and J. W. Costerton, "Hydrophobic Bile-Salt Inhibits Bacterial Adhesion on Biliary Stent Material," Dig. Dis. Sci., 39, 999-1006 (1994). https://doi.org/10.1007/BF02087551
  26. E. Kullman, F. Frozanpor, C. Soderlund, S. Linder, P. Sandstrom, A. Lindhoff-Larsson, E. Toth, G. Lindell, E. Jonas, J. Freedman, M. Ljungman, C. Rudberg, B. Ohlin, R. Zacharias, C. E. Leijonmarck, K. Teder, A. Ringman, G. Persson, M. Gozen, and O. Eriksson, "Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study," Gastrointest. Endosc., 72, 915-923 (2010). https://doi.org/10.1016/j.gie.2010.07.036
  27. J. J. Telford, D. L. Carr-Locke, T. H. Baron, J. M. Poneros, B. C. Bounds, P. B. Kelsey, R. H. Schapiro, C. S. Huang, D. R. Lichtenstein, B. C. Jacobson, J. R. Saltzman, C. C. Thompson, D. G. Forcione, C. J. Gostout, and W. R. Brugge, "A randomized trial comparing uncovered and partially covered self-expandable metal stents in the palliation of distal malignant biliary obstruction," Gastrointest. Endosc., 72, 907-914 (2010). https://doi.org/10.1016/j.gie.2010.08.021
  28. M. Krokidis, F. Fanelli, G. Orgera, D. Tsetis, I. Mouzas, M. Bezzi, E. Kouroumalis, R. Pasariello, and A. Hatzidakis, "Percutaneous palliation of pancreatic head cancer: randomized comparison of ePTFE/FEP-covered versus uncovered nitinol biliary stents," Cardiovasc. Intervent. Radiol., 34, 352-361 (2011). https://doi.org/10.1007/s00270-010-9880-4
  29. A. Abdel Samie and L. Theilmann, "Fully Covered Self-Expandable Metal Stents for Treatment of Both Benign and Malignant Biliary Disorders," Diagnostic and therapeutic endoscopy. (DOI=10.1155/ 2012/498617) (2012).