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. 2018 Jan 16;10(1):16-22.
doi: 10.4253/wjge.v10.i1.16.

New 14-mm diameter Niti-S biliary uncovered metal stent for unresectable distal biliary malignant obstruction

Masataka Kikuyama  1 , Naofumi Shirane  1 , Shinya Kawaguchi  1 , Shuzou Terada  1 , Tsuyoshi Mukai  1 , Ken Sugimoto  1
Affiliations

New 14-mm diameter Niti-S biliary uncovered metal stent for unresectable distal biliary malignant obstruction

Masataka Kikuyama et al. World J Gastrointest Endosc. .

Abstract

Aim: To investigate whether an uncovered self-expandable metal stent (UCSEMS) with a large diameter could prevent recurrent biliary obstruction (RBO).

Methods: Thirty-eight patients with malignant biliary obstruction underwent treatment with an UCSEMS with a 14-mm diameter (Niti-S 14). Retrospectively, we evaluated technical and functional success rate, RBO rate, time to RBO, survival time, and adverse events in these patients.

Results: Stent placement success and functional success were achieved in all patients. Two patients (5.3%) had RBO due to tumor ingrowth or overgrowth. The median time to RBO was 190 (range, 164-215) d. The median survival time was 120 (range, 18-502) d. The 6-mo non-RBO rate was 91%. Other adverse events other than RBO occurred as follows: Acute cholecystitis, post-ERCP pancreatitis, hemobilia, and fever without exacerbation of liver injury, and liver abscess in 4 (10.3%), 3 (7.9%), 2 (5.3%), 1 (2.6%), and 1 (2.6%), respectively. Migration of the stents was not observed.

Conclusion: Niti-S 14 is considered to be a preferable metal stent because of a low rate of RBO with no migration.

Keywords: Adverse event; Bile duct cancer; Ingrowth; Malignant biliary obstruction; Metal stent; Migration; Overgrowth; Pancreatic cancer; Pancreatitis; Recurrent biliary obstruction.

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Conflict of interest statement

Conflict-of-interest statement: Authors declare no conflicts of interest for this article.

Figures

Figure 1
Figure 1
Niti-S 14 appearance with a braided structure made from nitinol, and a large diameter of 14 mm with a length of 60 or 80 mm.
Figure 2
Figure 2
Stent placement of Niti-S 14 after sphincterotomy in pancreatic cancer. A: Endoscopic view; B: Picture of endoscopic retrograde pancreatocholangiography.
Figure 3
Figure 3
Endoscopic view of the duodenal major papilla after Niti-S 14 placement. The bile duct cavity is maintained despite bile duct mucosa or tumor growth into the stent.
Figure 4
Figure 4
Kaplan-Meier analysis of stent patency. The non-RBO rates of 3, 6 and 12 mo were 100%, 91% and 78%, respectively. RBO: Recurrent biliary obstruction.
Figure 5
Figure 5
Kaplan-Meier analysis of survival. The median survival time was 120 d.
See this image and copyright information in PMC

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