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Modified Combined Stent‐by‐stent and Stent‐in‐stent Method for Tri‐sectoral Metal Stenting in Patients with Malignant Hilar Biliary Obstruction by Inoue, Tadahisa; Kitano, Rena; Yoneda, Masashi is a Medicine article available to read on EtoBox.

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BRIEF EXPLANATION I T HAS RECENTLY been reported that combined simultaneous stent-by-stent (SBS) and stent-in-stent (SIS) method (SBSIS) can reduce the technical difficulty of tri-sectoral metal stenting for high-grade malignant hilar biliary obstruction (MHBO). 1-4 However, inserting a third metal stent (MS) remains challenging. 4 More recently, simultaneous triple SBS placement using ultra-thin delivery systems has helped avoid failures of the third MS insertion, but this technique cannot be performed for non-largediameter common bile ducts. 5 We therefore developed a "modified" SBSIS method to make insertion of the third MS more straightforward. A 76-year-old woman developed obstructive jaundice due to unresectable Bismuth type IIIa MHBO. As pre-drainage using two plastic stents was insufficient, tri-sectoral MS placement was performed. After insertion of three 0.025inch guidewires in the left hepatic duct (LHD), right anterior hepatic duct (aRHD), and right posterior hepatic duct (pRHD), two MSs (ZeoStent V; Zeon Medical, Tokyo, Japan) were simultaneously inserted into the LHD and pRHD. The pRHD MS was subsequently placed across the stricture. A tapered catheter was inserted ov

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Author

Inoue, Tadahisa; Kitano, Rena; Yoneda, Masashi

Publisher

John Wiley and Sons; Wiley (Blackwell Publishing); Blackwell Publishing Inc.; Wiley (ISSN 0915-5635)

Published

2020

Language

EN

Field

Medicine (Health Sciences)