Background: A conformable self-expandable metallic stent was developed to overcome the limitation of previous self-expandable metallic stents. The aim of this study was to evaluate outcomes after placement of conformable covered and uncovered self-expandable metallic stents for palliation of malignant gastroduodenal obstruction.

Methods: A single-blind, randomized, parallel-group, prospective study were conducted in 4 medical centres between March 2009 and July 2012. 134 patients with unresectable malignant gastroduodenal obstruction were assigned to a covered double-layered (n=66) or uncovered unfixed-cell braided (n=68) stent placement group. Primary analysis was performed to compare re-intervention rates between two groups.

Results: 120 patients were analysed (59 in the covered group and 61 in the uncovered group). Overall rates of re-intervention were not significantly different between the two groups: 13/59 (22.0%) in the covered group vs. 13/61 (21.3%) in the uncovered group, p=0.999. Stent migration was more frequent in the covered group than in the uncovered group (p=0.003). The tumour ingrowth rate was higher in the uncovered group than in the covered group (p=0.016).

Conclusions: The rates of re-intervention did not significantly differ between the two stents. Conformable covered double-layered and uncovered unfixed-cell braided stents were associated with different patterns of stent malfunction.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.dld.2014.02.024DOI Listing

Publication Analysis

Top Keywords

self-expandable metallic
16
covered group
16
uncovered group
16
conformable covered
12
metallic stents
12
malignant gastroduodenal
12
group
9
uncovered
8
uncovered self-expandable
8
stents palliation
8

Similar Publications

Background And Aim: Although long self-expandable metal stent (SEMS) with a sufficient intragastric portion is typically preferred for endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), this design can complicate endoscopic re-intervention for recurrent biliary obstruction (RBO). We evaluated the efficacy and safety of endoscopic re-intervention for RBO through the stent after EUS-HGS using a novel partially covered SEMS with an anchoring flange.

Methods: The partially covered SEMS was designed with a intrahepatic uncovered portion measuring 1.

View Article and Find Full Text PDF

Background And Aim: Stent placement for biliary drainage in patients with malignant hilar biliary obstruction (MHBO) has been a topic of long-standing debate, and the best approach remains controversial. Therefore, we aimed to evaluate the efficacy, safety, and removability of multi-hole fully covered self-expandable metal stents (MH-FCSEMSs) in a preclinical experiment using swine hilar bile duct obstruction (HBDO) models and to assess the feasibility and safety of stent placement in patients with MHBO.

Methods: Three minipigs underwent endoscopic retrograde cholangiopancreatography (ERCP)-guided endobiliary-radio frequency ablation (EB-RFA) to establish Bismuth type II hilar bile duct stenosis models.

View Article and Find Full Text PDF

Pancreaticojejunostomy (PJ) is a critical step in pancreaticoduodenectomy (PD), often complicated by the risk of postoperative pancreatic fistula (POPF). This video report demonstrates a novel robotic PJ technique employing a self-expandable metallic stent. The method involves the use of the Da Vinci Xi robotic system and the WallFlex™ Biliary RX Stent for improved anastomotic support, particularly in high-risk cases defined by soft pancreatic texture and narrow duct diameter (<3 mm).

View Article and Find Full Text PDF

Unlabelled: Pulmonary vein (PV) stenosis is a rare complication following PV isolation (PVI) for atrial fibrillation. Despite the benefit of early intervention, screening is not conducted, emphasizing the importance of maintaining a high index of suspicion. Standardized management approaches are unavailable for this serious complication.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!