Endoscopic Deployment of Multiple JOSTENT SelfX Is Effective and Safe in Treatment of Malignant Hilar Biliary Strictures

Hirofumi Kawamoto, Koichiro Tsutsumi, Ryo Harada, Masakuni Fujii, Hironari Katou, Ken Hirao, Naoko Kurihara, Takashi Nakanishi, Osamu Mizuno, Etsuji Ishida, Tsuneyoshi Ogawa, Hirotoshi Fukatsu, Kohsaku Sakaguchi

Research output: Contribution to journalArticle

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Abstract

Background & Aims: For the treatment of unresectable biliary tract carcinoma with hilar biliary stricture, antitumor therapy and biliary stenting should be addressed in terms of prolonged survival with a good quality of life. However, the endoscopic management of malignant hilar biliary strictures is difficult even for an expert endoscopist. We evaluated the efficacy and safety of the endoscopic deployment of multiple JOSTENT SelfX units in patients with hilar biliary strictures treated with or without chemotherapy. Methods: Between November 2003 and December 2006, endoscopic deployment of multiple JOSTENT SelfX units in hilar biliary strictures by using a partial stent-in-stent procedure was performed on 41 consecutive patients with primary cholangiocarcinoma (n = 34) and gallbladder carcinoma (n = 7) at a gastroenterologic center of Okayama University Hospital. Thirty-three patients were treated with gemcitabine (n = 25) or S-1 (n = 8). Results: Metallic stent deployment was successfully accomplished in all cases via only endoscopic procedures. During the follow-up period (mean, 210 days), mean patency time was 150 days, and metallic stent obstruction occurred in 15 cases (37%). Although a repeat intervention was required in all metallic stent obstructed cases, the deployment of the second metallic or plastic stent was completed successfully. The remaining 26 cases (63%) required no interventions. The median overall survival period was only 235 days. However, that of the patients receiving chemotherapy was 392 days. Conclusions: Endoscopic partial stent-in-stent deployment with multiple JOSTENT SelfX prostheses is effective and safe for the treatment of malignant hilar biliary stricture even in patients receiving chemotherapy.

Original languageEnglish
Pages (from-to)401-408
Number of pages8
JournalClinical Gastroenterology and Hepatology
Volume6
Issue number4
DOIs
Publication statusPublished - Apr 2008

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Stents
Pathologic Constriction
Therapeutics
gemcitabine
Drug Therapy
Carcinoma
Survival
Cholangiocarcinoma
Biliary Tract
Gallbladder
Plastics
Prostheses and Implants
Quality of Life
Safety

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Endoscopic Deployment of Multiple JOSTENT SelfX Is Effective and Safe in Treatment of Malignant Hilar Biliary Strictures. / Kawamoto, Hirofumi; Tsutsumi, Koichiro; Harada, Ryo; Fujii, Masakuni; Katou, Hironari; Hirao, Ken; Kurihara, Naoko; Nakanishi, Takashi; Mizuno, Osamu; Ishida, Etsuji; Ogawa, Tsuneyoshi; Fukatsu, Hirotoshi; Sakaguchi, Kohsaku.

In: Clinical Gastroenterology and Hepatology, Vol. 6, No. 4, 04.2008, p. 401-408.

Research output: Contribution to journalArticle

Kawamoto, H, Tsutsumi, K, Harada, R, Fujii, M, Katou, H, Hirao, K, Kurihara, N, Nakanishi, T, Mizuno, O, Ishida, E, Ogawa, T, Fukatsu, H & Sakaguchi, K 2008, 'Endoscopic Deployment of Multiple JOSTENT SelfX Is Effective and Safe in Treatment of Malignant Hilar Biliary Strictures', Clinical Gastroenterology and Hepatology, vol. 6, no. 4, pp. 401-408. https://doi.org/10.1016/j.cgh.2007.12.036
Kawamoto, Hirofumi ; Tsutsumi, Koichiro ; Harada, Ryo ; Fujii, Masakuni ; Katou, Hironari ; Hirao, Ken ; Kurihara, Naoko ; Nakanishi, Takashi ; Mizuno, Osamu ; Ishida, Etsuji ; Ogawa, Tsuneyoshi ; Fukatsu, Hirotoshi ; Sakaguchi, Kohsaku. / Endoscopic Deployment of Multiple JOSTENT SelfX Is Effective and Safe in Treatment of Malignant Hilar Biliary Strictures. In: Clinical Gastroenterology and Hepatology. 2008 ; Vol. 6, No. 4. pp. 401-408.
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AU - Kawamoto, Hirofumi

AU - Tsutsumi, Koichiro

AU - Harada, Ryo

AU - Fujii, Masakuni

AU - Katou, Hironari

AU - Hirao, Ken

AU - Kurihara, Naoko

AU - Nakanishi, Takashi

AU - Mizuno, Osamu

AU - Ishida, Etsuji

AU - Ogawa, Tsuneyoshi

AU - Fukatsu, Hirotoshi

AU - Sakaguchi, Kohsaku

PY - 2008/4

Y1 - 2008/4

N2 - Background & Aims: For the treatment of unresectable biliary tract carcinoma with hilar biliary stricture, antitumor therapy and biliary stenting should be addressed in terms of prolonged survival with a good quality of life. However, the endoscopic management of malignant hilar biliary strictures is difficult even for an expert endoscopist. We evaluated the efficacy and safety of the endoscopic deployment of multiple JOSTENT SelfX units in patients with hilar biliary strictures treated with or without chemotherapy. Methods: Between November 2003 and December 2006, endoscopic deployment of multiple JOSTENT SelfX units in hilar biliary strictures by using a partial stent-in-stent procedure was performed on 41 consecutive patients with primary cholangiocarcinoma (n = 34) and gallbladder carcinoma (n = 7) at a gastroenterologic center of Okayama University Hospital. Thirty-three patients were treated with gemcitabine (n = 25) or S-1 (n = 8). Results: Metallic stent deployment was successfully accomplished in all cases via only endoscopic procedures. During the follow-up period (mean, 210 days), mean patency time was 150 days, and metallic stent obstruction occurred in 15 cases (37%). Although a repeat intervention was required in all metallic stent obstructed cases, the deployment of the second metallic or plastic stent was completed successfully. The remaining 26 cases (63%) required no interventions. The median overall survival period was only 235 days. However, that of the patients receiving chemotherapy was 392 days. Conclusions: Endoscopic partial stent-in-stent deployment with multiple JOSTENT SelfX prostheses is effective and safe for the treatment of malignant hilar biliary stricture even in patients receiving chemotherapy.

AB - Background & Aims: For the treatment of unresectable biliary tract carcinoma with hilar biliary stricture, antitumor therapy and biliary stenting should be addressed in terms of prolonged survival with a good quality of life. However, the endoscopic management of malignant hilar biliary strictures is difficult even for an expert endoscopist. We evaluated the efficacy and safety of the endoscopic deployment of multiple JOSTENT SelfX units in patients with hilar biliary strictures treated with or without chemotherapy. Methods: Between November 2003 and December 2006, endoscopic deployment of multiple JOSTENT SelfX units in hilar biliary strictures by using a partial stent-in-stent procedure was performed on 41 consecutive patients with primary cholangiocarcinoma (n = 34) and gallbladder carcinoma (n = 7) at a gastroenterologic center of Okayama University Hospital. Thirty-three patients were treated with gemcitabine (n = 25) or S-1 (n = 8). Results: Metallic stent deployment was successfully accomplished in all cases via only endoscopic procedures. During the follow-up period (mean, 210 days), mean patency time was 150 days, and metallic stent obstruction occurred in 15 cases (37%). Although a repeat intervention was required in all metallic stent obstructed cases, the deployment of the second metallic or plastic stent was completed successfully. The remaining 26 cases (63%) required no interventions. The median overall survival period was only 235 days. However, that of the patients receiving chemotherapy was 392 days. Conclusions: Endoscopic partial stent-in-stent deployment with multiple JOSTENT SelfX prostheses is effective and safe for the treatment of malignant hilar biliary stricture even in patients receiving chemotherapy.

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