Benefits of side-by-side deployment of 6-mm covered self-expandable metal stents for hilar malignant biliary obstructions

BackgroundThe best way to perform endoscopic stenting for hilar malignant biliary obstruction (HMBO) is under discussion. Recently, a 6-mm covered self-expandable metal stent (CSEMS) has become available. In this article, the results of side-by-side (SBS) 6-mm CSEMS deployment for HMBO are reported. MethodsA total of 22 patients, 32 procedures of SBS 6-mm CSEMS [16 fully covered (FCSEMS), 16 partially covered (PCSEMS)] deployment for HMBO, were prospectively enrolled from November 2011 to June 2015 and retrospectively analyzed. Technical and clinical success rates, stent patency period, complications, and re-intervention success rates were analyzed. ResultsThe overall/FCSEMS/PCSEMS technical and clinical success rates were 96.9%/93.8%/100% and 93.5%/100%/87.5%, respectively. The mean stent patency period was 95/113/68days. Early and late complication rates were 3.1%/0%/6.3% and 6.3%/12.5%/0%, respectively. Stent exchange was attempted in 12 procedures, and the stent exchange success rate was 83.3%/100%/75%. ConclusionsThis is the first report of SBS 6-mm CSEMS deployment for HMBO. This procedure has high technical and clinical success rates and the advantages of ease of performance and a high success rate of re-intervention. Outcomes appear better with FCSEMS than with PCSEMS deployment. Since stent patency is still controversial, large-sample studies are needed.