Reintervention (RI) after bilateral metal stent placement for malignant hilar biliary obstruction is a highly technically challenging procedure. This study aimed to examine the use of a novel J-tip guidewire (GW) for RI after stent-by-stent (SBS) placement. The study outcomes included technical success, procedure time, and procedure-related adverse events (AEs) associated with RI after SBS placement. These parameters were compared between 20 patients who underwent RI using the J-tip GW (J-GW group) and a control cohort of 20 patients who underwent RI using a conventional GW (C-GW group). The technical success rate for GW placement without any advanced technique was significantly higher in the J-GW group than in the C-GW group. The median procedure time was significantly shorter in the J-GW group. No significant differences in the procedure-related AE rate were observed between the groups. The novel J-tip GW yielded higher technical success rates with appropriate GW placement and shorter procedure time for RI after SBS placement, simplifying and streamlining the RI procedure.
Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
References
1
Lee TH,
Kim TH,
Moon JH.
et al. Bilateral versus unilateral placement of metal stents for inoperable high-grade malignant hilar biliary strictures: a multicenter, prospective, randomized study (with video). Gastrointest Endosc 2017; 86: 817-827
2
Naitoh I,
Inoue T,
Hayashi K.
Which is better for unresectable malignant hilar biliary obstruction: side-by-side versus stent-in-stent?. Gastrointest Interv 2018; 7: 78-84
4
Inoue T,
Ibusuki M,
Kitano R.
et al. Combined side-by-side and stent-in-stent method for triple metal stenting in patients with malignant hilar biliary obstruction. Dig Endosc 2019; 31: 698-705
5
Tomoda T,
Kato H,
Kawamoto H.
et al. Usefulness of a newly designed plastic stent for endoscopic re-intervention in patients with malignant hilar biliary obstruction. Endoscopy 2017; 49: 1087-1091
6
Inoue T,
Naitoh I,
Okumura F.
et al. Reintervention for stent occlusion after bilateral self-expandable metallic stent placement for malignant hilar biliary obstruction. Dig Endosc 2016; 28: 731-737
8
Okuno M,
Mukai T,
Iwashita T.
et al. Evaluation of endoscopic reintervention for self-expandable metallic stent obstruction after stent-in-stent placement for malignant hilar biliary obstruction. J Hepatobiliary Pancreat Sci 2019; 26: 211-218
9
Son JH,
Lee HS,
Lee SH.
et al. Revision of bilateral self-expandable metallic stents placed using the stent-in-stent technique for malignant hilar biliary obstruction. Hepatobiliary Pancreat Dis Int 2018; 17: 437-442
10
Inoue T,
Naitoh I,
Suzuki Y.
et al. Multi-center study of endoscopic revision after side-by-side metal stent placement for malignant hilar biliary obstruction. Dig Endosc 2021; 33: 807-814