Erschienen in:
Open Access
01.01.2008
Stenting and interventional radiology for obstructive jaundice in patients with unresectable biliary tract carcinomas
verfasst von:
Toshio Tsuyuguchi, Tadahiro Takada, Masaru Miyazaki, Shuichi Miyakawa, Kazuhiro Tsukada, Masato Nagino, Satoshi Kondo, Junji Furuse, Hiroya Saito, Masafumi Suyama, Fumio Kimura, Hideyuki Yoshitomi, Satoshi Nozawa, Masahiro Yoshida, Keita Wada, Hodaka Amano, Fumihiko Miura
Erschienen in:
Journal of Hepato-Biliary-Pancreatic Sciences
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Ausgabe 1/2008
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Abstract
Together with biliary drainage, which is an appropriate procedure for unresectable biliary cancer, biliary stent placement is used to improve symptoms associated with jaundice. Owing to investigations comparing percutaneous transhepatic biliary drainage (PTBD), surgical drainage, and endoscopic drainage, many types of stents are now available that can be placed endoscopically. The stents used are classified roughly as plastic stents and metal stents. Compared with plastic stents, metal stents are of large diameter, and have long-term patency (although they are expensive). For this reason, the use of metal stents is preferred for patients who are expected to survive for more than 6 months, whereas for patients who are likely to survive for less than 6 months, the use of plastic stents is not considered to be improper. Obstruction in a metal stent is caused by a tumor that grows within the stent through the mesh interstices. To overcome such problems, a covered metal stent was developed, and these stents are now used in patients with malignant distal biliary obstruction. However, this type of stent has been reported to have several shortcomings, such as being associated with the development of acute cholecystitis and stent migration. In spite of these shortcomings, evidence is expected to demonstrate its superiority over other types of stent.