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
Surgical oncology
Therapy
Radiation oncology
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