CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(10): E1288-E1292
DOI: 10.1055/a-0998-7847
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Owner and Copyright © Georg Thieme Verlag KG 2019

Hybrid placement technique for hepatic hilar obstruction using a new uncovered self-expandable metal stent

Takeshi Ogura
1  Premier Development Research of Medicine, Osaka Medical College, Osaka, Japan
2  2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
,
Masanori Yamada
2  2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
,
Saori Ueno
2  2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
,
Shinya Fukunishi
1  Premier Development Research of Medicine, Osaka Medical College, Osaka, Japan
2  2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
,
Kazuhide Higuchi
2  2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Publikationsverlauf

submitted 11. April 2019

accepted after revision 17. Juni 2019

Publikationsdatum:
01. Oktober 2019 (online)

  

Abstract

Background and study aim Recently, a novel technique combining stent-in-stent (SIS) and side-by-side (SBS) technique (hybrid technique) has been reported. This technique may have application for hepatic hilar obstruction (HBO) because it reduces the number of times the stent mesh has to be passed. However, to the best our knowledge, evaluation of its use in that setting has not been reported. Recently, a new uncovered self-expandable metal stent (UCSEMS) has become available in Japan. The diameter of this stent delivery shaft is only 5.4 Fr, and the discrepancy between the guidewire and top of stent delivery system is strongly reduced. We herein report technical tips for hybrid metal stent deployment for high-grade HBO using this novel UCSEMS. 

Hybrid metal stent deployment using he novel UCSEMS was attempted in seven patients. Technical success was obtained in all patients. Mean procedure time was 33.3 minutes (range, 27 to 43). Clinical success was obtained in six patients. Median stent patency was 109 days (range, 48 – 160 days).

In conclusion, the hybrid metal stent placement technique appears to be useful using the new UCSEMS because of its fine-gauge stent delivery system.