Biliary malignancy: Distal

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Self-expandable metal stents (SEMSs) have been shown to provide superior palliation for unresectable biliary obstruction when compared to plastic stents (PSs). Most studies have confirmed that SEMS patency is twice as long as that of PSs, with a decreased need for hospital readmission and endoscopic re-intervention for recurrent biliary obstruction. It has been over 10 years since a covered SEMS (CSEMS) was first introduced; however, clinical data are still insufficient to conclude that the covered SEMS is more beneficial than the bare type. Tumor ingrowth is the most common cause of occlusion in bare SEMS, whereas impaction of food or sludge is the most common cause in CSEMSs. No studies have demonstrated significant improvement in stent patency or patient survival; thus, so far, it is still controversial which type of SEMS is superior. Although SEMSs have longer stent patency than PSs, the stent occlusion rate for both covered and uncovered SEMS is between 20% and 38%. Various stent-related complications including stent migration, cholangitis, cholecystitis, pancreatitis, and hemobilia have been reported. Recently, modifications of SEMS design have been made to reduce these complications. Through these efforts, significant advances in flexibility and conformability of SEMS have reduced the rate of stent migration. In addition, phase II and III clinical trials of drug-eluting stent (DES) with antitumor effect are currently in progress. Functioning stents with improved design are expected to be available in the future. In this chapter, outcomes (plastic vs. SEMS, bare vs. covered SEMS), complications, and future of SEMS for biliary malignant obstruction are reviewed.

Original languageEnglish
Title of host publicationSelf-Expandable Stents in the Gastrointestinal Tract
PublisherSpringer New York
Pages235-248
Number of pages14
ISBN (Electronic)9781461437468
ISBN (Print)1461437458, 9781461437451
DOIs
Publication statusPublished - 2013 Oct 1

Fingerprint

Stents
Neoplasms
Plastics
Self Expandable Metallic Stents
Hemobilia
Patient Readmission
Phase III Clinical Trials
Phase II Clinical Trials
Cholecystitis
Drug-Eluting Stents
Cholangitis
Sewage
Pancreatitis
Food
Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Lee, D. K. (2013). Biliary malignancy: Distal. In Self-Expandable Stents in the Gastrointestinal Tract (pp. 235-248). Springer New York. https://doi.org/10.1007/978-1-4614-3746-8_16
Lee, Dong Ki. / Biliary malignancy : Distal. Self-Expandable Stents in the Gastrointestinal Tract. Springer New York, 2013. pp. 235-248
@inbook{ec473b5d45e74a5fb63d0278d555dee5,
title = "Biliary malignancy: Distal",
abstract = "Self-expandable metal stents (SEMSs) have been shown to provide superior palliation for unresectable biliary obstruction when compared to plastic stents (PSs). Most studies have confirmed that SEMS patency is twice as long as that of PSs, with a decreased need for hospital readmission and endoscopic re-intervention for recurrent biliary obstruction. It has been over 10 years since a covered SEMS (CSEMS) was first introduced; however, clinical data are still insufficient to conclude that the covered SEMS is more beneficial than the bare type. Tumor ingrowth is the most common cause of occlusion in bare SEMS, whereas impaction of food or sludge is the most common cause in CSEMSs. No studies have demonstrated significant improvement in stent patency or patient survival; thus, so far, it is still controversial which type of SEMS is superior. Although SEMSs have longer stent patency than PSs, the stent occlusion rate for both covered and uncovered SEMS is between 20{\%} and 38{\%}. Various stent-related complications including stent migration, cholangitis, cholecystitis, pancreatitis, and hemobilia have been reported. Recently, modifications of SEMS design have been made to reduce these complications. Through these efforts, significant advances in flexibility and conformability of SEMS have reduced the rate of stent migration. In addition, phase II and III clinical trials of drug-eluting stent (DES) with antitumor effect are currently in progress. Functioning stents with improved design are expected to be available in the future. In this chapter, outcomes (plastic vs. SEMS, bare vs. covered SEMS), complications, and future of SEMS for biliary malignant obstruction are reviewed.",
author = "Lee, {Dong Ki}",
year = "2013",
month = "10",
day = "1",
doi = "10.1007/978-1-4614-3746-8_16",
language = "English",
isbn = "1461437458",
pages = "235--248",
booktitle = "Self-Expandable Stents in the Gastrointestinal Tract",
publisher = "Springer New York",
address = "United States",

}

Lee, DK 2013, Biliary malignancy: Distal. in Self-Expandable Stents in the Gastrointestinal Tract. Springer New York, pp. 235-248. https://doi.org/10.1007/978-1-4614-3746-8_16

Biliary malignancy : Distal. / Lee, Dong Ki.

Self-Expandable Stents in the Gastrointestinal Tract. Springer New York, 2013. p. 235-248.

Research output: Chapter in Book/Report/Conference proceedingChapter

TY - CHAP

T1 - Biliary malignancy

T2 - Distal

AU - Lee, Dong Ki

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Self-expandable metal stents (SEMSs) have been shown to provide superior palliation for unresectable biliary obstruction when compared to plastic stents (PSs). Most studies have confirmed that SEMS patency is twice as long as that of PSs, with a decreased need for hospital readmission and endoscopic re-intervention for recurrent biliary obstruction. It has been over 10 years since a covered SEMS (CSEMS) was first introduced; however, clinical data are still insufficient to conclude that the covered SEMS is more beneficial than the bare type. Tumor ingrowth is the most common cause of occlusion in bare SEMS, whereas impaction of food or sludge is the most common cause in CSEMSs. No studies have demonstrated significant improvement in stent patency or patient survival; thus, so far, it is still controversial which type of SEMS is superior. Although SEMSs have longer stent patency than PSs, the stent occlusion rate for both covered and uncovered SEMS is between 20% and 38%. Various stent-related complications including stent migration, cholangitis, cholecystitis, pancreatitis, and hemobilia have been reported. Recently, modifications of SEMS design have been made to reduce these complications. Through these efforts, significant advances in flexibility and conformability of SEMS have reduced the rate of stent migration. In addition, phase II and III clinical trials of drug-eluting stent (DES) with antitumor effect are currently in progress. Functioning stents with improved design are expected to be available in the future. In this chapter, outcomes (plastic vs. SEMS, bare vs. covered SEMS), complications, and future of SEMS for biliary malignant obstruction are reviewed.

AB - Self-expandable metal stents (SEMSs) have been shown to provide superior palliation for unresectable biliary obstruction when compared to plastic stents (PSs). Most studies have confirmed that SEMS patency is twice as long as that of PSs, with a decreased need for hospital readmission and endoscopic re-intervention for recurrent biliary obstruction. It has been over 10 years since a covered SEMS (CSEMS) was first introduced; however, clinical data are still insufficient to conclude that the covered SEMS is more beneficial than the bare type. Tumor ingrowth is the most common cause of occlusion in bare SEMS, whereas impaction of food or sludge is the most common cause in CSEMSs. No studies have demonstrated significant improvement in stent patency or patient survival; thus, so far, it is still controversial which type of SEMS is superior. Although SEMSs have longer stent patency than PSs, the stent occlusion rate for both covered and uncovered SEMS is between 20% and 38%. Various stent-related complications including stent migration, cholangitis, cholecystitis, pancreatitis, and hemobilia have been reported. Recently, modifications of SEMS design have been made to reduce these complications. Through these efforts, significant advances in flexibility and conformability of SEMS have reduced the rate of stent migration. In addition, phase II and III clinical trials of drug-eluting stent (DES) with antitumor effect are currently in progress. Functioning stents with improved design are expected to be available in the future. In this chapter, outcomes (plastic vs. SEMS, bare vs. covered SEMS), complications, and future of SEMS for biliary malignant obstruction are reviewed.

UR - http://www.scopus.com/inward/record.url?scp=84930318780&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930318780&partnerID=8YFLogxK

U2 - 10.1007/978-1-4614-3746-8_16

DO - 10.1007/978-1-4614-3746-8_16

M3 - Chapter

AN - SCOPUS:84930318780

SN - 1461437458

SN - 9781461437451

SP - 235

EP - 248

BT - Self-Expandable Stents in the Gastrointestinal Tract

PB - Springer New York

ER -

Lee DK. Biliary malignancy: Distal. In Self-Expandable Stents in the Gastrointestinal Tract. Springer New York. 2013. p. 235-248 https://doi.org/10.1007/978-1-4614-3746-8_16