P-127 - Efficacy of Y-Shaped Bilateral Self-Expandable Metallic Stent Placement in Patients with Unresectable Hilar Cholangiocarcinoma

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Hepatobiliary Cancers
Palliative Care
Surgery and/or Radiotherapy of Cancer
Presenter J.J. Hyun
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors J.J. Hyun1, H.S. Choi1, H.J. Chun1, I.K. Yoo1, J.M. Lee1, S.H. Kim1, E.S. Kim1, B. Keum1, Y.T. Jeen2, H.S. Lee1, C.D. Kim1, S.J. Nam1
  • 1Korea University College of Medicine, Seoul/KR
  • 2Department of Internal Medicine, Seoul/KR

Abstract

Introduction

Bilateral biliary stenting is the palliative treatment for biliary drainage in patients with hilar cholangiocarcinoma. However there are few studies on the outcomes of Y-shaped bilateral self-expandable metallic stent placement. The aim of our study is to evaluate the clinical efficacies of endoscopic bilateral metal stenting using Y-stent for the management of malignant hilar obstruction.

Methods

We performed a retrospective review of prospectively collected data for Y-shaped biliary stent placement, from January 2010 to December 2014, in two tertiary medical centers. The outcomes were assessed by the overall survival, complication, and recurrence of jaundice.

Results

A total of 23 Y-stent placement procedures were performed in patients with hilar cholangiocarcinoma. The mean age was 77.4 ± 7.2 years and 56.5% (13/23) were male patients. The tumor according to Bismuth classification was type II in 8 patients (34.8%), type IIIa in 5 (21.7%), type IIIb in 1 (4.3%), and type IV in 9 (39.1%). Technical success was achieved in 91.3% (21/23) and reduction of serum bilirubin showed in 94.7% (18/19) after Y-stent placement. After the procedure, 9 of the 23 patients (39.1%) had died during the follow-up, and mean survival time was 18.6 ± 4.5 (9.8-27.4) months (Fig.1). There was no procedure-related mortality. The recurrence of jaundice was occurred in 8 patients (34.8%) and the mean time of occurrence of stent clogging was 8.1 ± 5.7 months.

Conclusion

Y-shaped bilateral metal stent placement is a safe and effective procedure for unresectable hilar cholangiocarcinoma. Larger prospective series and randomized controlled trials would be required to assess the long-term effect.

Figure: P-127