Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
J Hepatobiliary Pancreat Sci. 2011 Sep;18(5):653-7. doi: 10.1007/s00534-011-0407-4.
BACKGROUND/PURPOSE: Whether unilateral or bilateral drainage should be performed for malignant hilar biliary obstruction is controversial. Moreover, endoscopic placement of bilateral metallic stents is difficult and complicated.
New metallic stents, such as the Niti-S Y-type stent (Y-stent), BONASTENT M-Hilar, and Niti-S large cell D-type stent (LCD), have recently been developed for bilateral stent-in-stent procedures to facilitate contralateral stent deployment through the interstices of the first metallic stent. We review the features and efficacy of these metallic stents designed for bilateral drainage in patients with hilar biliary obstruction.
The newly designed stents examined exhibited high technical success rates, low stent-related complications, and good stent patency. Endoscopic reinterventions for occluded stents could be performed easily, particularly in patients with bilateral LCD placement.
Endoscopic bilateral stenting using newly designed metallic stents is feasible, safe, and effective in patients with unresectable malignant hilar biliary obstruction.
背景/目的：对于恶性肝门胆管梗阻，应该进行单侧还是双侧引流存在争议。此外，内镜下双侧金属支架置入术既困难又复杂。
新型金属支架，如 Niti-S Y 型支架（Y 支架）、BONASTENT M-Hilar 和 Niti-S 大细胞 D 型支架（LCD），最近已被开发用于双侧支架内支架置入术，以通过第一个金属支架的间隙方便对侧支架的部署。我们回顾了这些专为肝门胆管梗阻患者双侧引流而设计的金属支架的特点和疗效。
检查的新型支架显示出较高的技术成功率、较低的支架相关并发症和良好的支架通畅率。对于阻塞的支架，可以很容易地进行内镜再介入治疗，尤其是在双侧放置 LCD 的患者中。
对于不可切除的恶性肝门胆管梗阻患者，使用新型设计的金属支架进行内镜下双侧支架置入术是可行、安全且有效的。
