Skip to main content

Advertisement

SpringerLink
Log in

Percutaneous insertion of Zilver stent in malignant biliary obstruction

  • UPDATE
  • Published:
Abdominal Imaging Aims and scope Submit manuscript

An Erratum to this article was published on 24 February 2011

Abstract

Background

We evaluated the clinical efficacy and technical feasibility of the percutaneously inserted self-expandable nitinol stent (Zilver stent) for palliation of malignant biliary obstruction.

Methods

Seventeen patients with malignant tumors involving the intra- or extrahepatic bile duct who presented with obstructive jaundice underwent percutaneous insertion of a self-expandable nitinol stent. We retrospectively reviewed the hospital records of patients and evaluated the technical feasibility on stent placement, complications, patient survival, and duration of stent patency.

Results

Percutaneous biliary stenting with 27 Zilver stents was performed in 17 patients with malignant biliary obstruction. Technical success was 95%. Malposition of the stent was encountered in one patient. Minor technical problems were encountered in two patients: the introducer tip was broken during stent insertion, so endoscopic removal was done. Mean follow-up period for the 17 patients was 182 days (range 29–485 days): nine patients died of progressive disease at a mean follow-up of 151 days (range 61–371days) after stent insertion and eight patients remained alive at the final follow-up of 216 days (range 29–485 days). The median survival period for all patients was 277 days. The stent occlusion rate was 26% and the mean patency period was 280 days. In five patients, seven stents were obstructed by tumor ingrowth and overgrowth. Stent patency rates were 100%, 100%, 75%, 61%, and 41% at 1, 2, 3, 6, and 12 months, respectively. A late complication, erosive bleeding of the hepatic artery by the stent, developed in one patient.

Conclusion

Percutaneous biliary stenting using the nitinol stent is technically feasible and safe and clinically efficacious treatment for malignant biliary obstruction, even with a minor technical problem during stent insertion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5

Similar content being viewed by others

References

  1. Carrasco CH, Wallace S, Charnsangavej C. Expandable biliary endoprosthesis: an experimental study. AJR 1985;145:1279–1281

    PubMed  CAS  Google Scholar 

  2. Davids PHP, Groen AK, Rauws EA, et al. Randomized trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction. Lancet 1992;340:1488–1492

    Article  PubMed  CAS  Google Scholar 

  3. Adam A, Chettly N, Roddie M, et al. Self-expanding stainless steel endoprostheses for treatment of malignant bile duct obstruction. AJR 1991;156:321–325

    PubMed  CAS  Google Scholar 

  4. Coons HG. Self-expanding stainless steel biliary stents. Radiology 1989;170:979–983

    PubMed  CAS  Google Scholar 

  5. Gillams A, Dick R, Dooley JS, et al. Self-expandable stainless steel braided endoprosthesis for biliary strictures. Radiology 1990;174:137–140

    PubMed  CAS  Google Scholar 

  6. Irving JD, Adam A, Dick R, et al. Gianturco expandable metallic biliary stents: results of a European clinical trial. Radiology 1989;172:321–326

    PubMed  CAS  Google Scholar 

  7. Lammer JS, Klein GE, Kleinert R, et al. Obstructive jaundice: use of expandable metal endoprosthesis for biliary drainage. Radiology 1990;177:789–792

    PubMed  CAS  Google Scholar 

  8. Lameris JS, Stocker J, Nijs HG. Malignant biliary obstruction: percutaneous use of self-expandable stents. Radiology 1991;179:703–707

    PubMed  CAS  Google Scholar 

  9. Yoshioka T, Sakaguchi H, Yoshimura H. Expandable metallic biliary endoprostheses: preliminary clinical evaluation. Radiology 1990;177:253–257

    PubMed  CAS  Google Scholar 

  10. Bezzi M, Orsi F, Salvatori FM, et al. Self-expandable nitinol stent for the management of biliary obstruction: long-term clinical results. J Vasc Interv Radiol 1994;5:287–293

    Article  PubMed  CAS  Google Scholar 

  11. Rossi P, Bezzi M, Rossi M. Metallic stents in malignant biliary obstruction: results of a multicenter European study of 240 patients. J Vasc Interv Radiol 1994;5:279–285

    Article  PubMed  CAS  Google Scholar 

  12. Mathieson JR, McLoughlin RF, Cooperberg PL. Malignant obstruction of the common bile duct: long-term results of Gianturco-Rosch metal stents used as initial treatment. Radiology 1994;192:663–667

    PubMed  CAS  Google Scholar 

  13. Watkinson A. Hepatobiliary intervention. In: Watkinson A, Adam A (eds). Interventional radiology, a practical guide. Oxford: Oxon Radcliffe Medical Press, 1996:pp 59

    Google Scholar 

  14. Gordon RL, Ring EJ, LaBerge JM, Doherty MM. Malignant biliary obstruction: treatment with expandable metallic stents: follow-up of 50 consecutive patients. Radiology 1992;182:697–701

    PubMed  CAS  Google Scholar 

  15. Inal M, Akgul E, Aksungur E, Seydaoglu G. Percutaneous placement of biliary metallic stents in patients with malignant hilar obstruction: unilobar versus bilobar drainage. J Vasc Interv Radiol 2003;14:1409–1416

    PubMed  Google Scholar 

  16. Lee MJ, Dawson SL, Mueller PR, et al. Palliation of malignant bile duct obstruction with metallic biliary endoprostheses: technique, results, and complications. J Vasc Interv Radiol 1992;3:665–671

    Article  PubMed  CAS  Google Scholar 

  17. Stoker J, Lameris JS, van Blankestein M. Percutaneous metallic self-expandable endoprostheses in malignant hilar biliary obstruction. Gastrointest Endosc 1993;39:43–49

    Article  PubMed  CAS  Google Scholar 

  18. Brountzos EN, Petropoulos E, Kelekis NL. Malignant biliary obstruction: management with percutaneous metallic stent placement. Hepatogastroenterology 1999;46:2764–2771

    PubMed  CAS  Google Scholar 

  19. Oikarinen H, Leinonen S, Karttunen A. Patency and complications of percutaneously inserted metallic stents in malignant biliary obstruction. J Vasc Interv Radiol 1999;10:1387–1393

    Article  PubMed  CAS  Google Scholar 

  20. Han YM, Hwang SB, Lee ST, et al. Polyurethane-covered self-expandable nitinol stent for malignant biliary obstruction: preliminary results. Cardiovasc Interv Radiol 2002;25:381–387

    Article  Google Scholar 

  21. Han YM, Jin GY, Lee SO, Kwak HS, Chung GH. Flared polyurethane-covered self-expandable nitinol stent for malignant biliary obstruction. J Vasc Interv Radiol 2003;14:1291–1301

    PubMed  Google Scholar 

  22. Varadarajulu S, Tutuian R, Gostout C, et al. Efficacy of the Za self-expandable metal stent for palliation of malignant biliary obstruction. J Clin Gastroenterol 2004;38:77–80

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This study was supported by a 2003 scientific research grant from Inje University.

Author information

Authors and Affiliations

  1. Department of Radiology, Ilsan Paik Hospital, Medical College of Inje University, 2240, Daewha-dong, Ilsan-gu, Goyang-si, Gyonggi-do, 411-706, Korea

    Y. H. Han, M.-Y. Kim, S. Y. Kim, Y. H. Kim, Y. J. Hwang, J. W. Seo, S. J. Cha & G. Hur

Authors
  1. Y. H. Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M.-Y. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Y. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y. H. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y. J. Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. W. Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. J. Cha
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G. Hur
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Y. H. Han.

Additional information

An erratum to this article can be found online at http://dx.doi.org/10.1007/s00261-011-9714-0

Rights and permissions

Reprints and permissions

About this article

Cite this article

Han, Y.H., Kim, MY., Kim, S.Y. et al. Percutaneous insertion of Zilver stent in malignant biliary obstruction. Abdom Imaging 31, 433–438 (2006). https://doi.org/10.1007/s00261-005-8017-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-005-8017-8

Keywords

Search

Navigation