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. 2024 Jan;34(1):538-547.
doi: 10.1007/s00330-023-10024-4. Epub 2023 Aug 4.

Percutaneous insertion of long-covered biliary stents in patients with malignant duodenobiliary stricture

Chang Hoon Oh  1 , Dong Il Gwon  2 , Hee Ho Chu  3 , Gi-Young Ko  3 , Gun Ha Kim  3 , Sang Lim Choi  4 , Sung Won Kim  5
Affiliations

Percutaneous insertion of long-covered biliary stents in patients with malignant duodenobiliary stricture

Chang Hoon Oh et al. Eur Radiol. 2024 Jan.

Abstract

Objective: To investigate the technical feasibility, safety, and efficacy of a long-covered biliary stent in patients with malignant duodenobiliary stricture.

Methods: This retrospective study enrolled 57 consecutive patients (34 men, 23 women; mean age, 64 years; range, 32-85 years) who presented with malignant duodenobiliary stricture between February 2019 and November 2020. All patients were treated with a long (18 or 23 cm)-covered biliary stent.

Results: The biliary stent deployment was technically successful in all 57 patients. The overall adverse event rate was 17.5% (10 of 57 patients). Successful internal drainage was achieved in 55 (96.5%) of 57 patients. The median patient survival and stent patency times were 99 days (95% confidence interval [CI], 58-140 days) and 73 days (95% CI, 60-86 days), respectively. Fourteen (25.5%) of the fifty-five patients presented with biliary stent dysfunction due to sludge (n = 11), tumor overgrowth (n = 1), collapse of the long biliary stent by a subsequently inserted additional duodenal stent (n = 1), or rapidly progressed duodenal cancer (n = 1). A univariate Cox proportional hazards model did not reveal any independent predictor of biliary stent patency.

Conclusions: Percutaneous insertion of a subsequent biliary stent was technically feasible after duodenal stent insertion. Percutaneous insertion of a long-covered biliary stent was safe and effective in patients with malignant duodenobiliary stricture.

Clinical relevance statement: In patients with malignant duodenobiliary stricture, percutaneous insertion of a long-covered biliary stent was safe and effective regardless of duodenal stent placement.

Key points: • Percutaneous insertion of long-covered biliary stents in patients with malignant duodenobiliary stricture is a safe and effective procedure. • Biliary stent deployment was technically successful in all 57 patients and successful internal drainage was achieved in 55 (96.5%) of 57 patients. • The median patient survival and stent patency times were 99 days and 73 days, respectively, after placement of a long-covered biliary stent in patients with duodenobiliary stricture.

Keywords: Biliary tract; Duodenal obstruction; Feasibility studies; Neoplasms; Stents.

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