Primary Clinical Application of Y-Shaped Jogged Stent Implantation in Patients with Malignant Hilar Biliary Obstruction

J Gastrointest Surg. 2019 Apr;23(4):745-750. doi: 10.1007/s11605-019-04131-1. Epub 2019 Feb 21.

Abstract

Objective: To assess the feasibility, safety, and efficacy of Y-shaped jogged stent in patients with malignant hilar biliary obstruction.

Methods: A total of 196 patients with malignant hilar biliary obstruction treated by biliary tract stent implantation from August 2010 to August 2017 were retrospectively reviewed. Seventeen consecutive patients who were treated with Y-shaped jogged stent implantation were identified as the Y-shaped jogged stent implantation group. Seventeen matched patients undergoing unilateral stent placement combined with percutaneous transhepatic cholangial drainage (PTCD) were enrolled as the control group. Baseline characteristics of patients, stent patency time, and survival time were compared.

Results: There was no significant difference in the age, gender, tumor type and stage, biliary obstruction classification, bilirubin level at diagnosis, presence of metastasis, or chemotherapy between the Y-stent group and the control group (P > 0.05). One week after surgery, the reduction rate of bilirubin was significantly higher in the Y-stent group (88.2% vs 53.0%, P < 0.05). The mean stent patency time was longer in the Y-stent group (7.3 ± 1.0 months vs 5.7 ± 0.9 months, P < 0.05). The mean survival time of the Y-stent group (9.1 ± 1.5 months) was longer than the control group (7.2 ± 1.1 months, P > 0.05). There was no severe complication occurred in both two groups.

Conclusion: Y-shaped jogged stent implantation was a safe, feasible, and effective approach in the treatment of patients with malignant hilar biliary obstruction, with the significantly prolonged stent patency time and survival time.

Keywords: Malignant hilar biliary obstruction; Retrospectively; Stent patency time; Survival time; Y-shaped jogged stent.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bile Duct Neoplasms / complications
  • Biliary Tract Surgical Procedures / instrumentation*
  • Biliary Tract Surgical Procedures / methods
  • Cholangiography
  • Cholestasis / etiology
  • Cholestasis / surgery*
  • Digestive System Neoplasms / complications*
  • Drainage / instrumentation
  • Drainage / methods
  • Equipment Design
  • Feasibility Studies
  • Female
  • Gallbladder Neoplasms / complications
  • Humans
  • Liver Neoplasms / complications
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / complications
  • Retrospective Studies
  • Stents*
  • Stomach Neoplasms / complications
  • Survival Rate
  • Treatment Outcome