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Fracture of a biliary expandable metallic stent

2004; Elsevier BV; Volume: 60; Issue: 4 Linguagem: Inglês

10.1016/s0016-5107(04)01884-x

1097-6779

Hiroshi Yoshida, Takashi Tajiri, Yasuhiro Mamada, Nobuhiko Taniai, Youichi Kawano, Yoshiaki Mizuguchi, Yasuo Arima, Eiji Uchida, Hirofumi Misawa,

Biliary and Gastrointestinal Fistulas

Survival is limited for patients with malignant biliary obstruction who are not candidates for surgical resection. The objective of palliation by placement of a biliary stent is to relieve symptoms related to obstructive jaundice, to prevent cholangitis, and possibly to prolong survival. Biliary stent insertion improves the quality of life for patients. 1. Wagner H.J. Knyrim K. Vakil N. Klose K.J. Plastic endoprostheses versus metal stents in the palliative treatment of malignant hilar biliary obstruction. A prospective and randomised trial. Endoscopy. 1993; 25: 213-218 Crossref PubMed Scopus (330) Google Scholar Expandable metallic stents are considered more suitable for this indication than plastic stents because they can be introduced with a smaller delivery catheter, have a larger inner diameter, and remain fixed in position after release. 2. Yoshida H. Tajiri T. Mamada Y. Taniai N. Kawano Y. Mizuguchi Y. et al. One-step insertion of an expandable metallic stent for unresectable common bile duct carcinoma. J Nippon Med Sch. 2003; 70: 179-182 Crossref PubMed Scopus (9) Google Scholar , 3. Rossi P. Bezzi M. Rossi M. Adam A. Chetty N. Roddie M.E. et al. Metallic stents in malignant biliary obstruction: results of a multicenter European study of 240 patients. J Vasc Interv Radiol. 1994; 5: 279-285 Abstract Full Text PDF PubMed Scopus (218) Google Scholar , 4. Stoker J. Lameris J.S. Complications of percutaneously inserted biliary Wallstents. J Vasc Interv Radiol. 1993; 4: 767-772 Abstract Full Text PDF PubMed Scopus (99) Google Scholar , 5. Knyrim K. Wagner H.J. Pausch J. Vakil N. A prospective randomised controlled trial of metal stents for malignant obstruction of the common bile duct. Endoscopy. 1993; 25: 207-212 Crossref PubMed Scopus (503) Google Scholar , 6. Lee M.J. Dawson S.L. Mueller P.R. Krebs T.L. Saini S. Hahn P.F. Palliation of malignant bile duct obstruction with metallic biliary endoprostheses: technique, results, and complications. J Vasc Interv Radiol. 1992; 3: 665-671 Abstract Full Text PDF PubMed Scopus (59) Google Scholar Complications of metallic stent placement for malignant bile-duct obstruction include tumor ingrowth and overgrowth, 4. Stoker J. Lameris J.S. Complications of percutaneously inserted biliary Wallstents. J Vasc Interv Radiol. 1993; 4: 767-772 Abstract Full Text PDF PubMed Scopus (99) Google Scholar , 7. Becker C.D. Glatti A. Maibach R. Baer H.U. Percutaneous palliation of malignant obstructive jaundice with the Wallstent endoprosthesis: follow-up and reintervention in patients with hilar and non-hilar obstruction. J Vasc Interv Radiol. 1993; 4: 597-604 Abstract Full Text PDF PubMed Scopus (106) Google Scholar perforation, 8. Schaafsma R.J. Spoelstra P. Pakan J. Huibregtse K. Sigmoid perforation: a rare complication of a migrated biliary endoprosthesis. Endoscopy. 1996; 28: 469-470 Crossref PubMed Scopus (35) Google Scholar , 9. Marsman J.W. Hoedemaker H.P. Necrotizing fasciitis: fatal complication of migrated biliary stent. Australas Radiol. 1996; 40: 80-83 Crossref PubMed Scopus (4) Google Scholar and stent migration. 10. Pescatore P. Meier-Willersen H.J. Manegold B.C. A severe complication of the new self-expanding spiral nitinol biliary stent. Endoscopy. 1997; 29: 412-415 Crossref Scopus (27) Google Scholar This report describes a case in which a biliary expandable metallic stent fractured several months after placement in a patient with an unresectable pancreatic carcinoma.