Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction

Background. Palliative therapies for malignant biliary obstruction (MBO) include choledochojejunostomy and self-expanding metallic stent (SEMS) insertion. Fractures following SEMS insertion in MBO treatment are scarce. Objective. To assess the clinical features of biliary stent fractures and evaluat...

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Main Authors: Chuanguo Zhou, Baojie Wei, Jianfeng Wang, Qiang Huang, Hui Li, Kun Gao
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2018/6527879
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author Chuanguo Zhou
Baojie Wei
Jianfeng Wang
Qiang Huang
Hui Li
Kun Gao
author_facet Chuanguo Zhou
Baojie Wei
Jianfeng Wang
Qiang Huang
Hui Li
Kun Gao
author_sort Chuanguo Zhou
collection DOAJ
description Background. Palliative therapies for malignant biliary obstruction (MBO) include choledochojejunostomy and self-expanding metallic stent (SEMS) insertion. Fractures following SEMS insertion in MBO treatment are scarce. Objective. To assess the clinical features of biliary stent fractures and evaluate associated factors. Methods. One hundred fifty-six consecutive patients who underwent biliary SEMS placement for MBO treatment at Beijing Chaoyang Hospital affiliated to Capital Medical University, in 2010–2015, were evaluated retrospectively. Demographics, clinical features, stent parameters and patency times, and survival times were collected. Across the ampulla of Vater, balloon dilatation, number of stents, stent patency time, and survival time were compared between the stent and nonstent fracture groups. Results. There were 168 biliary metallic stents inserted in 156 patients, including 144 and 12 patients with one and 2-3 stents, respectively. Pre- and/or postballoon dilation was performed in 107 patients. Stents across and above the duodenal papilla were used in 105 and 51 patients, respectively. Six cases (3.8%) with stent occlusion had stent fractures. Single- and multiple-stent fracture rates were 4/144 (2.8%) and 2/12 (16.7%), respectively. Fracture times after stent deployment were 126.8 ± 79.0 (median, 115.5) days. Stent patency times in the stent and nonstent fracture groups were 151.8 ± 67.8 (median, 160.5) days and 159.3 ± 73.6 (median, 165.5) days, respectively. Overall survival times in the stent and nonstent fracture groups were 399.7 ± 147.6 (median, 364.0) days and 283.7 ± 126.1 (median, 289.0) days, respectively. Conclusion. Stent fractures following MBO treatment constitute a relatively rare long-term complication. Though there were no factors found to be significantly associated with SEMSs fracture, a trend could be observed towards more fractures in multistent, transpapillary, and balloon dilation groups.
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spelling doaj-art-7c0647875ff84518bb4b529f1698f6f32025-08-20T02:06:57ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/65278796527879Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary ObstructionChuanguo Zhou0Baojie Wei1Jianfeng Wang2Qiang Huang3Hui Li4Kun Gao5Department of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing 100020, ChinaDepartment of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing 100020, ChinaDepartment of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing 100020, ChinaDepartment of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing 100020, ChinaDepartment of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing 100020, ChinaDepartment of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing 100020, ChinaBackground. Palliative therapies for malignant biliary obstruction (MBO) include choledochojejunostomy and self-expanding metallic stent (SEMS) insertion. Fractures following SEMS insertion in MBO treatment are scarce. Objective. To assess the clinical features of biliary stent fractures and evaluate associated factors. Methods. One hundred fifty-six consecutive patients who underwent biliary SEMS placement for MBO treatment at Beijing Chaoyang Hospital affiliated to Capital Medical University, in 2010–2015, were evaluated retrospectively. Demographics, clinical features, stent parameters and patency times, and survival times were collected. Across the ampulla of Vater, balloon dilatation, number of stents, stent patency time, and survival time were compared between the stent and nonstent fracture groups. Results. There were 168 biliary metallic stents inserted in 156 patients, including 144 and 12 patients with one and 2-3 stents, respectively. Pre- and/or postballoon dilation was performed in 107 patients. Stents across and above the duodenal papilla were used in 105 and 51 patients, respectively. Six cases (3.8%) with stent occlusion had stent fractures. Single- and multiple-stent fracture rates were 4/144 (2.8%) and 2/12 (16.7%), respectively. Fracture times after stent deployment were 126.8 ± 79.0 (median, 115.5) days. Stent patency times in the stent and nonstent fracture groups were 151.8 ± 67.8 (median, 160.5) days and 159.3 ± 73.6 (median, 165.5) days, respectively. Overall survival times in the stent and nonstent fracture groups were 399.7 ± 147.6 (median, 364.0) days and 283.7 ± 126.1 (median, 289.0) days, respectively. Conclusion. Stent fractures following MBO treatment constitute a relatively rare long-term complication. Though there were no factors found to be significantly associated with SEMSs fracture, a trend could be observed towards more fractures in multistent, transpapillary, and balloon dilation groups.http://dx.doi.org/10.1155/2018/6527879
spellingShingle Chuanguo Zhou
Baojie Wei
Jianfeng Wang
Qiang Huang
Hui Li
Kun Gao
Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction
Gastroenterology Research and Practice
title Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction
title_full Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction
title_fullStr Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction
title_full_unstemmed Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction
title_short Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction
title_sort self expanding metallic stent fracture in the treatment of malignant biliary obstruction
url http://dx.doi.org/10.1155/2018/6527879
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