ENDOSCOPIC MANAGEMENT OF OCCLUDED METALLIC STENTS DEPLOYED FOR MALIGNANT HILAR BILIARY STRICTURE

DOI
  • KATO Hironari
    Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.
  • TOMODA Takeshi
    Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.
  • MATSUMOTO Kazuyuki
    Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.
  • HORIGUCHI Shigeru
    Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.
  • TSUTSUMI Koichiro
    Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.
  • OKADA Hiroyuki
    Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.

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Other Title
  • 悪性肝門部胆管狭窄症例における金属ステント閉塞への対処

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Description

<p>Endoscopic management of occluded metallic stents deployed for malignant hilar biliary stricture is technically demanding. Understanding the characteristics of devices such as guidewires, catheters, and stents, and handling these devices skillfully are essential for successful management. The passage of catheters and plastic stents (PS) through the mesh of metallic stents (MS) is the most difficult of all procedures for multiple occluded MS that had been deployed by the stent-in-stent method, and requires precise and careful maneuvering of the endoscope and other devices. The order of PS deployment into the occluded MS is also important. The order of PS deployment has to be same as that of the previous MS deployment. Skilled techniques of not only endoscopists but also their assistants are necessary for the successful management of multiple occluded MS deployed at the hilar portion. Therefore, it is important for endoscopists to become skilled in maneuvering guidewires in daily examinations.</p>

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