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KMID : 0359020080360060354
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Korean Journal of Gastrointestinal Endoscopy
2008 Volume.36 No. 6 p.354 ~ p.360
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A Preliminary Study on the Usefullness of a Zilver Stent for Bilateral Stenting in Patients with Advanced Hilar Cholangiocarcinoma
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Eum Jae-Sup
Kang Dae-Hwan
Choi Cheol-Woong
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Abstract
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Background/Aims: Hilar cholangiocarcinomas have an extremely poor prognosis. Although endoscopic bilateral metal stenting with the “stent in stent” technique using a Y stent is currently employed to treat patients with an unresectable hilar cholangiocarcinoma, this method has limited application in cases of tight strictures. Furthermore, insertion of stents into the Y stent side (first stent side) is problematic in cases of tumor recurrence. We evaluated the clinical efficacy of the use of endoscopic bilateral metal stenting with the Zilver stent.
Methods: Seven patients with an unresectable Bismuth type III or IV hilar cholangiocarcinoma were included in this study. For endoscopic bilateral metal stenting, we first inserted a Y stent with a central wide-open mesh. The Zilver stent was placed into the contralateral hepatic duct through the central
portion of the Y stent.
Results: Both technical and functional success was achieved in seven patients (100%). The early complication rate was 0%, and late complications due to tumor recurrence occurred in 2 out of 7 (28.6%) patients. These patients were managed by the placement of additional stents or with the use of percutaneous transhepatic biliary drainage.
Conclusions: We suggest that a combination technique using Y and Zilver stents improves bilateral stenting for patients with advanced hilar cholangiocarcinoma and facilitates stent reinsertion in cases of tumor recurrence. (Korean J Gastrointest Endosc 2008;
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KEYWORD
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Ystent, Zilverstent, Hilarcholangiocarcinoma
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