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Pilot Study of Dumbbell-Type Covered Self-Expandable Metal Stent Deployment for Benign Pancreatic Duct Stricture (with Videos)

  • Tadahiro Yamada
  • Takeshi Ogura
  • Atsushi Okuda
  • Miyuki Imanishi
  • Rieko Kamiyama
  • Akira Miyano
  • Nobu Nishioka
  • Kazuhide Higuchi
Multimedia Article
  • 38 Downloads

Abstract

Background

Fully-covered, self-expandable metal stents (FCSEMS) have been deployed to treat symptomatic chronic pancreatitis (CP) complicated with main pancreatic duct (MPD) stricture. Although this strategy can be effective, it has the disadvantages of stent migration or stent-induced ductal change. Removal of an FCSEMS can also be challenging in the face of distal migration because of MPD stricture. Dumbbell-type FCSEMS have been developed to prevent stent-induced ductal changes and improve removability when treating benign biliary stricture. This stent might also confer clinical benefits upon patients with MPD stricture.

Aims

The present pilot study aimed to determine the feasibility and safety of deploying dumbbell-type FCSEMS in patients with CP complicated by MPD stricture.

Method

Stents were deployed in 22 patients with MPD stricture caused by CP and complicated by abdominal pain.

Results

Strictures were located at the head (n = 19), body (n = 2), and head and tail (n = 1) of the MPD. Stents were deployed above the papilla in three patients. All stents were deployed for a median duration of 142 (range, 49–190) days and removed. The resolution of MPD strictures was confirmed by pancreatography in 19 (86.3%) patients. Two metal stents that spontaneously tore during removal from two patients had otherwise functioned normally. Only three patients developed recurrent MPD stricture during a median follow-up of 419 (range, 261–484) days..

Conclusions

Deployment of a dumbbell-type FCSEMS seems feasible for MPD stricture, and the rate of adverse events is acceptable.

Keywords

Chronic pancreatitis Pancreatic duct stricture Endoscopic retrograde cholangiopancreatography Metal stent 

Notes

Author’s Contribution

Tadahiro Yamada and Takeshi Ogura wrote a paper. Takeshi Ogura, Rieko Kamiyama, Atsushi Okuda, Nobu Nishioka, Akira Miyano, Miyuki Imanishi, and Kazuhide Higuchi played roles of interpretation of data for the work, revising it critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Compliance with Ethical Standards

This pilot study proceeded at Osaka Medical College between August 2016 and June 2017 and was approved by the Institutional Review Board at our hospital. All patients provided written, informed consent to participate in the study.

Conflict of Interest

Tadahiro Yamada, Takeshi Ogura, Atsushi Okuda, Miyuki Imanishi, Rieko Kamiyama, Akira Miyano, Nobu Nishioka, and Kazuhide Higuchi declare that there are no conflicts of interest.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  • Tadahiro Yamada
    • 1
  • Takeshi Ogura
    • 1
  • Atsushi Okuda
    • 1
  • Miyuki Imanishi
    • 1
  • Rieko Kamiyama
    • 1
  • Akira Miyano
    • 1
  • Nobu Nishioka
    • 1
  • Kazuhide Higuchi
    • 1
  1. 1.2nd Department of Internal MedicineOsaka Medical CollegeOsakaJapan

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