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Takao Iemoto 2 Articles
A novel fully covered metal stent for unresectable malignant distal biliary obstruction: results of a multicenter prospective study
Arata Sakai, Atsuhiro Masuda, Takaaki Eguchi, Keisuke Furumatsu, Takao Iemoto, Shiei Yoshida, Yoshihiro Okabe, Kodai Yamanaka, Ikuya Miki, Saori Kakuyama, Yosuke Yagi, Daisuke Shirasaka, Shinya Kohashi, Takashi Kobayashi, Hideyuki Shiomi, Yuzo Kodama
Clin Endosc 2024;57(3):375-383.   Published online July 10, 2023
DOI: https://doi.org/10.5946/ce.2023.035
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Endoscopic self-expandable metal stent (SEMS) placement is currently the standard technique for treating unresectable malignant distal biliary obstructions (MDBO). Therefore, covered SEMS with longer stent patency and fewer migrations are required. This study aimed to assess the clinical performance of a novel, fully covered SEMS for unresectable MDBO.
Methods
This was a multicenter single-arm prospective study. The primary outcome was a non-obstruction rate at 6 months. The secondary outcomes were overall survival (OS), recurrent biliary obstruction (RBO), time to RBO (TRBO), technical and clinical success, and adverse events.
Results
A total of 73 patients were enrolled in this study. The non-obstruction rate at 6 months was 61%. The median OS and TRBO were 233 and 216 days, respectively. The technical and clinical success rates were 100% and 97%, respectively. Furthermore, the rate of occurrence of RBO and adverse events was 49% and 21%, respectively. The length of bile duct stenosis (<2.2 cm) was the only significant risk factor for stent migration.
Conclusions
The non-obstruction rate of a novel fully covered SEMS for MDBO is comparable to that reported earlier but shorter than expected. Short bile duct stenosis is a significant risk factor for stent migration.

Citations

Citations to this article as recorded by  
  • Endeavors to prevent stent malfunction: new insights into the risk factors for recurrent biliary obstruction
    Sung-Jo Bang
    Clinical Endoscopy.2024; 57(1): 56.     CrossRef
  • Understanding mechanical properties of biliary metal stents for wise stent selection
    Seok Jeong
    Clinical Endoscopy.2023; 56(5): 592.     CrossRef
  • 3,969 View
  • 93 Download
  • 1 Web of Science
  • 2 Crossref
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Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and Review
Arata Sakai, Hideyuki Shiomi, Takao Iemoto, Ryota Nakano, Takuya Ikegawa, Takashi Kobayashi, Atsuhiro Masuda, Yuzo Kodama
Clin Endosc 2020;53(4):491-496.   Published online March 3, 2020
DOI: https://doi.org/10.5946/ce.2019.145
AbstractAbstract PDFPubReaderePub
In this study, we assessed a series of our cases in which endoscopic self-expandable metal stents (SEMSs) were used to treat malignant afferent loop obstruction (ALO) that arose after pancreaticoduodenectomy (PD). We retrospectively examined the records of 7 patients who underwent endoscopic SEMS placement for malignant ALO following PD. Clinical success was achieved in all cases. The median procedure time was 30 min (range, 15–50 min). There were no cases of stent occlusion, and no procedure-related adverse events were encountered. All patients died of their primary disease, and the median overall survival period was 155 days (range, 96–374 days). A re-intervention involving endoscopic ultrasound-guided hepaticogastrostomy combined with antegrade stenting was performed for obstructive jaundice and acute cholangitis in 1 case. In conclusion, endoscopic SEMS placement may be an effective and safe treatment for malignant ALO that arises after PD.

Citations

Citations to this article as recorded by  
  • Early and late effects of endoscopic interventions in patients with malignant afferent loop syndrome: A single‐center experience and literature review
    Kenjiro Yamamoto, Takao Itoi, Yukitoshi Matsunami, Atsushi Sofuni, Takayoshi Tsuchiya, Shuntaro Mukai, Hiroyuki Kojima, Hirohito Minami, Ryosuke Nakatsubo, Ryosuke Tonozuka
    Journal of Hepato-Biliary-Pancreatic Sciences.2024; 31(2): 120.     CrossRef
  • Efficacy of endoscopic ultrasound‐guided gastroenterostomy using self‐expandable metallic stent for afferent loop syndrome: A single‐center retrospective study
    Yuya Hagiwara, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Akihiro Ohba, Yuki Kawasaki, Kotaro Takeshita, Tetsuro Takasaki, Daiki Agarie, Hidenobu Hara, Shin Yagi, Soma Fukuda, Masaru Kuwada, Daiki Yamashige, Kohei Okamoto, Mark Chatto, Shunsuke Kond
    Journal of Gastroenterology and Hepatology.2024; 39(10): 2136.     CrossRef
  • Successful metal stent placement using short single-balloon endoscope for afferent loop syndrome after pancreaticoduodenectomy
    Takuto Furukawa, Yuichi Takano, Jun Noda, Masataka Yamawaki, Tetsushi Azami, Fumitaka Niiya, Fumiya Nishimoto, Naotaka Maruoka, Masatsugu Nagahama
    Progress of Digestive Endoscopy.2024; 104(1): 98.     CrossRef
  • Antegrade metallic stent placement using a slim cholangioscope for malignant afferent loop obstruction
    Haruo Miwa, Ritsuko Oishi, Kazuki Endo, Hiromi Tsuchiya, Akihiro Funaoka, Yuichi Suzuki, Shin Maeda
    Endoscopy.2024; 56(S 01): E774.     CrossRef
  • The Role of Endoscopic Management in Afferent Loop Syndrome
    Clement Chun Ho Wu, Elizabeth Brindise, Rami El Abiad, Mouen A. Khashab
    Gut and Liver.2023; 17(3): 351.     CrossRef
  • Simultaneous stent placement for biliary and afferent loop obstruction due to tumor recurrence after pancreatoduodenectomy
    Tatsunori Satoh, Hirotoshi Ishiwatari, Kazuma Ishikawa, Hidenori Kimura, Hiroyuki Matsubayashi, Hiroyuki Ono
    Endoscopy.2022; 54(09): E524.     CrossRef
  • Extra-anatomic percutaneous stenting of a malignant afferent loop obstruction following pancreaticoduodenectomy
    Stefan Lam, Sarah Khan, Robert Hutchins, Tim Fotheringham
    International Journal of Gastrointestinal Intervention.2022; 11(2): 77.     CrossRef
  • Endoscopic Transluminal Stent Placement for Malignant Afferent Loop Obstruction
    Chinatsu Yonekura, Takashi Sasaki, Takafumi Mie, Takeshi Okamoto, Tsuyoshi Takeda, Takaaki Furukawa, Yuto Yamada, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
    Journal of Clinical Medicine.2022; 11(21): 6357.     CrossRef
  • Clinical management for malignant afferent loop obstruction
    Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Takashi Kobayashi, Yasutaka Yamada, Yuzo Kodama
    World Journal of Gastrointestinal Oncology.2021; 13(7): 684.     CrossRef
  • Clinical management for malignant afferent loop obstruction
    Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Takashi Kobayashi, Yasutaka Yamada, Yuzo Kodama
    World Journal of Gastrointestinal Oncology.2021; 13(7): 509.     CrossRef
  • Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome
    Hideyuki Shiomi, Arata Sakai, Ryota Nakano, Shogo Ota, Takashi Kobayashi, Atsuhiro Masuda, Hiroko Iijima
    Clinical Endoscopy.2021; 54(6): 810.     CrossRef
  • Percutaneous- and EUS-guided gastroenterostomy for malignant afferent limb syndrome
    Dayyan Adoor, Zachary L. Smith
    VideoGIE.2020; 5(11): 542.     CrossRef
  • 5,002 View
  • 110 Download
  • 9 Web of Science
  • 12 Crossref
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