Large-diameter therapeutic channel duodenoscope to facilitate simultaneous deployment of side-by-side self-expandable metal stents in hilar cholangiocarcinoma

Atif Saleem, Todd H. Baron, Christopher J. Gostout

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Hilar cholangiocarcinoma (CC) is unresectable in 80% to 90% of cases. Placement of side-by-side bilateral self-expandable metal stents (SEMSs) can be technically challenging in these patients because deployment of the first stent can preclude passage of the second stent. Methods: Using a prototype large-diameter therapeutic channel (6-mm) duodenoscope, we positioned guidewires into the right and left intrahepatic systems. Two predeployed uncovered SEMSs with 7.5F delivery systems were passed side by side over each guidewire and deployed simultaneously. Design: Observational clinical feasibility study. Setting: Tertiary referral center. Results: This technique was attempted in 6 patients with malignant hilar biliary obstruction. Successful placement was achieved in all, with significant improvement in symptoms and cholestasis. Limitations: Small number of patients. Conclusion: This simple technique using a prototype large-diameter therapeutic channel duodenoscope facilitates placement of bilateral side-by-side hilar SEMSs.

Original languageEnglish (US)
Pages (from-to)628-631
Number of pages4
JournalGastrointestinal Endoscopy
Volume72
Issue number3
DOIs
StatePublished - Sep 2010

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Duodenoscopes
Klatskin Tumor
Stents
Cholestasis
Feasibility Studies
Tertiary Care Centers
Therapeutics
Self Expandable Metallic Stents

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

Large-diameter therapeutic channel duodenoscope to facilitate simultaneous deployment of side-by-side self-expandable metal stents in hilar cholangiocarcinoma. / Saleem, Atif; Baron, Todd H.; Gostout, Christopher J.

In: Gastrointestinal Endoscopy, Vol. 72, No. 3, 09.2010, p. 628-631.

Research output: Contribution to journalArticle

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AB - Background: Hilar cholangiocarcinoma (CC) is unresectable in 80% to 90% of cases. Placement of side-by-side bilateral self-expandable metal stents (SEMSs) can be technically challenging in these patients because deployment of the first stent can preclude passage of the second stent. Methods: Using a prototype large-diameter therapeutic channel (6-mm) duodenoscope, we positioned guidewires into the right and left intrahepatic systems. Two predeployed uncovered SEMSs with 7.5F delivery systems were passed side by side over each guidewire and deployed simultaneously. Design: Observational clinical feasibility study. Setting: Tertiary referral center. Results: This technique was attempted in 6 patients with malignant hilar biliary obstruction. Successful placement was achieved in all, with significant improvement in symptoms and cholestasis. Limitations: Small number of patients. Conclusion: This simple technique using a prototype large-diameter therapeutic channel duodenoscope facilitates placement of bilateral side-by-side hilar SEMSs.

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