Controversial issues of biliary stenting in patients with proximal biliary obstruction
https://doi.org/10.16931/1995-5464.2021-3-79-88
Abstract
The management of biliary decompression in malignant hilar carcinoma remains controversial. This review shows the most relevant aspects of endoprosthetics for proximal biliary obstruction, including necessity of stenting and morphological verification before radical surgery, selection of approach to drain etc. The main contradictions and ways to solve them are presented in this article, based on evidence researches, international and expert consensus conferences.
About the Authors
J. V. KuleznevaRussian Federation
Julia V. Kulezneva – Doct. of Sci. (Med.), Professor of the Department of Surgical Diseases No. 2, Yevdokimov Moscow State University of Medicine and Dentistry, Head of the Radiology Department of the Loginov Moscow Clinical Scientific Center
20/1, Delegatskaya str., Moscow, 127473
86, Entuziastov highway, Moscow, 111123
Phone: +7-903-791-62-55
O. V. Melekhina
Russian Federation
Olga V. Melekhina – Cand. of Sci. (Med.), Senior Researcher of the Radiology Department
86, Entuziastov highway, Moscow, 111123
A. B. Musatov
Russian Federation
Alexey B. Musatov – Surgeon of the Radiology Department
86, Entuziastov highway, Moscow, 111123
M. G. Efanov
Russian Federation
Mikhail G. Efanov – Doct. of Sci. (Med.), Head of the Department of Hepatopancreatobiliary Surgery
86, Entuziastov highway, Moscow, 111123
V. V. Tsvirkun
Russian Federation
Viktor V. Tsvirkun – Doct. of Sci. (Med.), Professor, Chief Researcher
86, Entuziastov highway, Moscow, 111123
I. Yu. Nedoluzhko
Russian Federation
Ivan Yu. Nedoluzhko – Cand. of Sci. (Med.), Head of the Department of Surgical Endoscopy
86, Entuziastov highway, Moscow, 111123
K. V. Shishin
Russian Federation
Kirill V. Shishin – Doct. of Sci. (Med.), Head of the Endoscopy Department
86, Entuziastov highway, Moscow, 111123
K. K. Salnikov
Russian Federation
Konstantin K. Salnikov – Clinical Resident
86, Entuziastov highway, Moscow, 111123
D. F. Kantimerov
Russian Federation
Dayan F. Kantimerov – Clinical Resident
86, Entuziastov highway, Moscow, 111123
References
1. Ukai T., Oshima S., Kuriyama H., Aso R., Okamura J. A new device for external biliary drainage using percutaneous transhepatic cholangiography. Med. J. Osaka Univ. 1971; 22 (1): 85–95.
2. Uchida H., Kuroda C., Nakamura H., Sato T., Ohsmima S. Percutaneous external and internal drainage of biliary tract with special reference to technique and diagnostic evaluation of follow-up cholangiography (author's transl.). Nihon Igaku Hoshasen Gakkai Zasshi. 1975; 35 (2): 53–67.
3. Irving J.D., Adam A., Dick R., Dondelinger R.F., Lunderquist A., Roche A. Gianturco expandable metallic biliary stents: results of a European clinical trial. Radiology. 1989; 172 (2): 321–326. https://doi.org/10.1148/radiology.172.2.2664861
4. Kulezneva Yu.V., Melekhina O.V., Efanov M.G., Alikhanov R.B., Musatov A.B., Ogneva A.Yu., Tsvirkun V.V. Disputable issues of biliary drainage procedures in malignant obstructive jaundice. Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 2019; 24 (4): 111–122. https://doi.org/10.16931/1995-5464.20194111-122 (In Russian)
5. Shapovalianz S.G., Budzinskiy S.A., Fedorov E.D., Bakhtiozina D.V. Long-term results of endoscopic transpapillary treatment of postoperative biliary strictures. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2017; 22 (3): 29–35. https://doi.org/10.16931/1995-5464.2017329-35 (In Russian)
6. Okhotnikov O.I., Yakovleva M.V., Gorbacheva O.S., Pakhomov V.I. Using of a coated self-expanding endobiliary stent for temporary restoration of biliary tract after iatrogenic injury. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2017; 22 (3): 87–92. https://doi.org/10.16931/1995-5464.2017387-92 (In Russian)
7. Galperin E.I., Akhaladze G.G., Vetshev P.S., Dyuzheva T.G. Differentiated approach to the minimally invasive management of malignant obstructive jaundice. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2019; 24 (2): 10–24. https://doi.org/10.16931/1995-5464.2019210-24 (In Russian)
8. Resolution of Hepato-Pancreato-Biliary Association of Common wealth of Independent States Executive Board Plenary Session “Minimally invasive technologies for obstructive jaundice”. 29–30 April 2019, Erevan, Armenia. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2019; 24 (2): 124–127. https://doi.org/10.16931/1995-5464.20192124–127 (In Russian)
9. Mansfield S.D., Barakat O., Charnley R.M., Jaques B.C., O'Suilleabhain C.B., Atherton P.J., Manas D. Management of hilar cholangiocarcinoma in the North of England: pathology, treatment, and outcome. World J. Gastroenterol. 2005; 11 (48): 7625–7630. https://doi.org/10.3748/wjg.v11.i48.7625
10. Kang M.J., Choi Y.-S., Jang J.-Y., Han I.W., Kim S.-W. Catheter tract recurrence after percutaneous biliary drainage for hilar cholangiocarcinoma. World J. Surg. 2013; 37 (2): 437–442. https://doi.org/10.1007/s00268-012-1844-1
11. Hakuta R., Kogure H., Nakai Y., Kawakami H., Maguchi H., Mukai T., Iwashita T., Saito T., Togawa O., Matsubara S., Hayashi T., Maetani I., Ito Y., Hasebe O., Itoi T., Hanada K., Isayama H. Unilateral versus bilateral endoscopic nasobiliary drainage and subsequent metal stent placement for unresectable malignant hilar obstruction: a multicenter randomized controlled trial. J. Clin. Med. 2021; 10 (2): 206. https://doi.org/10.3390/jcm10020206
12. Cotton P.B. Income and outcome metrics for the objective evaluation of ERCP and alternative methods. Gastrointest. Endosc. 2002; 56 (6 Suppl): S283–290. https://doi.org/10.1067/mge.2002.129025
13. Schutz S.M., Abbott R.M. Grading ERCPs by degree of difficulty: a new concept to produce more meaningful outcome data. Gastrointest. Endosc. 2000; 51 (5): 535–539. https://doi.org/10.1016/s0016-5107(00)70285-9
14. Cheng J.L.S., Bruno M.J., Bergman J.J., Rauws E.A., Tytgat G.N., Huibregtse K. Endoscopic palliation of patients with biliary obstruction caused by nonresectable hilarcholangiocarcinoma: Efficacy of self-expandable metallic Wall stents. Gastrointest. Endosc. 2002; 56 (1): 33–39. https://doi.org/10.1067/mge.2002.125364
15. Deviere J., Baize M., de Toeuf J., Cremer M. Long-term followup of patients with hilar malignant stricture treated by endoscopic internal biliary drainage. Gastrointest. Endosc. 1988; 34 (2): 95–101. https://doi.org/10.1016/s0016-5107(88)71271-7
16. Dumas R., Demuth N., Buckley M., Peten E.P., Manos T., Demarquay J.-F., Hastier P., Caroli-Bosc F.-X., Rampal P., Delmont J.-P. Endoscopic bilateral metal stent placement for malignant hilar stenoses: identification of optimal technique. Gastrointest. Endosc. 2000; 51 (3): 334–338. https://doi.org/10.1016/s0016-5107(00)70364-6
17. Banales J.M., Marin J.J.G., Lamarca A., Rodrigues P.M., Khan S.A., Roberts L.R., Cardinale V., Carpino G., Andersen J.B., Braconi C., Calvisi D.F., Perugorria M.J., Fabris L., Boulter L., Macias R.I.R., Gaudio E., Alvaro D., Gradilone S.A., Strazzabosco M., Marzioni M., Coulouarn C., Fouassier L., Raggi C., Invernizzi P., Mertens J.C., Moncsek A., Rizvi S., Heimbach J., Koerkamp B.G., Bruix J., Forner A., Bridgewater J., Valle J.W., Gores G.J. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat. Rev. Gastroenterol. Hepatol. 2020; 17 (9): 557–588. https://doi.org/10.1038/s41575-020-0310-z
18. Lee S.H., Park J.K., Yoon W.J., Lee J.K., Ryu J.K., Yoon Y.B., Kim Y.T. Optimal biliary drainage for inoperable Klatskin’s tumor based on Bismuth type. World J. Gastroenterol. 2007; 13 (29): 3948–3955. https://doi.org/10.3748/wjg.v13.i29.3948
19. Rerknimitr R., Kladcharoen N., Mahachai V., Kullavanijaya P. Result of endoscopic biliary drainage in hilar cholangiocarcinoma. J. Clin. Gastroenterol. 2004; 38 (6): 518–523. https://doi.org/10.1097/01.mcg.0000123204.36471.be
20. Xia M., Wang S., Wu J., Gao D., Ye X., Wang T., Zhao Y., Hu B. The risk of acute cholangitis after endoscopic stenting for malignant hilar strictures: a large comprehensive study. J. Gastroenterol. Hepatol. 2020; 35 (7): 1150–1157. https://doi.org/10.1111/jgh.14954
21. Rerknimitr R., Angsuwatcharakon P., Ratanachu-ek T., Khor C.J.L., Ponnudurai R., Moon J.H., Seo D.W., PantongragBrown L., Sangchan A., Pisespongsa P., Akaraviputh T., Reddy N.D., Maydeo A., Itoi T., Pausawasdi N., Punamiya S., Attasaranya S., Devereaux B., Ramchandani M., Goh K.-L. Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma. J. Gastroenterol. Hepatol. 2013; 28 (4): 593–607. https://doi.org/10.1111/jgh.12128
22. Dumonceau J., Tringali А., Papanikolaou I.S., Blero D., Mangiavillano B., Schmidt A., Vanbiervliet G., Costamagna G., Devière J., García-Cano J., Gyökeres T., Hassan C., Prat F., Siersema P.D., van Hooft J.E. Endoscopic biliary stenting: indications, choice of stents, and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline – updated October 2017. Endoscopy. 2018; 50 (9): 910–930. https://doi.org/10.1055/a-0659-9864
23. Costamagna G., Tringali A. Can we insert a covered stent, partially or not, in case of hilar biliary stenosis? Endosc. Internat. Open. 2017; 5 (12): E1218–E1219. https://doi.org/10.1055/s-0043-120665
24. Lee S.S., Song T.J., Joo M., Park D.H., Seo D.W., Sung K.L., Kim M.-H. Histological changes in the bile duct after long-term placement of a fully covered self-expandable metal stent within a common bile duct: a canine study. Clin. Endosc. 2014; 47 (1): 84–93. https://doi.org/10.5946/ce.2014.47.1.84
25. Deipolyi A.R., Covey A.M. Palliative percutaneous biliary interventions in malignant high bile duct obstruction. Semin. Intervent. Radiol. 2017; 34 (4): 361–368. https://doi.org/10.1055/s-0037-1608827
26. Khatkov I.E., Avanesyan R.G., Akhaladze G.G., Beburishvili A.G., Bulanov A.Yu., Bykov M.I., Virshke E.G., Gabriel S.A., Granov D.A., Darvin V.V., Dolgushin B.I., Dyuzheva T.G., Efanov M.G., Korobko V.L., Korolev M.P., Kulabukhov V.V., Maystrenko N.A., Melekhina O.V., Nedoluzhko I.Yu., Okhotnikov O.I., Pogrebnyakov V.Yu., Polikarpov A.A., Prudkov M.I., Ratnikov V.A., Solodinina E.N., Stepanova Yu.A., Subbotin V.V., Fedorov E.D., Shabunin A.V., Shapovalyants S.G., Shulutko A.M., Shishin K.V., Tsvirkun V.N., Chzhao A.V., Kulezneva Yu.V. Russian consensus on current issues in the diagnosis and treatment of obstructive jaundice syndrome. Pirogov Russian Journal of Surgery = Khirurgiya. Zhurnal imeni N.I. Pirogova. 2020; 6: 5–17. https://doi.org/10.17116/hirurgia20200615 (In Russian)
27. Nakai Y., Yamamoto R., Matsuyama M., Sakai Y., Takayama Y., Ushio J., Ito Y., Kitamura K., Ryozawa S., Imamura T., Tsuchida K., Hayama J., Itoi T., Kawaguchi Y., Yoshida Y., Sugimori K., Shimura K., Mizuide M., Iwai T., Nishikawa K., Yagioka H., Nagahama M., Toda N., Saito T., Yasuda I., Hirano K., Togawa O., Nakamura K., Maetani I., Sasahira N., Isayama H. Multicenter study of endoscopic preoperative biliary drainage for malignant hilar biliary obstruction: E-POD hilar study. J. Gastroenterol. Hepatol. 2018; 33 (5): 1146–1153. https://doi.org/10.1111/jgh.14050
28. Wetter L.A., Ring E.J., Pellegrini C.A., Way L.W. Differential diagnosis of sclerosing cholangiocarcinomas of the common hepatic duct (Klatskin tumors). Am. J. Surg. 1991; 161 (1): 57–62; discussion 62–63. https://doi.org/10.1016/0002-9610(91)90361-g
29. Verbeek P.C., van Leeuwen D.J., de Wit L.T., Reeders J.W., Smits N.J., Bosma A., Huibregtse K., van der Heyde M.N. Benign fibrosing disease at the hepatic confluence mimicking Klatskin tumors. Surgery. 1992; 112 (5): 866–871.
30. Juntermanns B., Kaiser G.M., Reis H., Saner F.H., Radunz S., Vernadakis S., Heuer M., Kuehl H., Paul A., Treckmann J. Klatskin-mimicking lesions: still a diagnostical and therapeutical dilemma? Hepatogastroenterology. 2011; 58 (106): 265–269.
31. Eckel F., Brunner T., Jelic S. ESMO Guidelines Working Group. Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2010; 21 Suppl 5: v65–9. https://doi.org/10.1093/annonc/mdq167
32. Breder V.V., Kosyrev V.Yu., Ledin E.V. Prakticheskie rekomendacii po lekarstvennomu lecheniyu biliarnogo raka [Practical guidance for drug regimes of biliary cancer. Malignant tumors: Practical guidance] RUSSCO #3s2, 2017; 7: 352–366. https://doi.org/10.18027/2224-5057-2017-7-3s2-352-366
33. Jo J.-H., Park B.-H. Suprapapillary versus transpapillary stent placement for malignant biliary obstruction: which is better? Vasc. Interv. Radiol. 2015; 26 (4): 573–582. https://doi.org/10.1016/j.jvir.2014.11.043
34. Okamoto T., Fujioka S., Yanagisawa S., Yanaga K., Kakutani H., Tajiri H., Urashima M. Placement of a metallic stent across the main duodenal papilla may predispose to cholangitis. Gastrointest. Endosc. 2006; 63 (6): 792–796. https://doi.org/10.1016/j.gie.2005.05.015
35. Misra S.P., Dwivedi M. Reflux of duodenal contents and cholangitis in patients undergoing self-expanding metal stent placement. Gastrointest. Endosc. 2009; 70 (2): 317–321. https://doi.org/10.1016/j.gie.2008.12.054
36. Takada R., Ikezawa K., Kiyota R., Imai T., Abe Y., Fukutake N., Ashida R., Nawa T., Tabuchi T., Katayama K., Ohkawa K. Self-expandable metallic stent placement above the papilla without endoscopic sphincterotomy in patients with distal malignant biliary obstruction. Endosc. Internat. Open. 2020; 8 (6): E753–E760. https://doi.org/10.1055/a-1135-8437
37. Dowsett J.F., Vaira D., Hatfield A.R., Cairns S.R., Polydorou A., Frost R., Croker J., Cotton P.B., Russell R.C., Mason R.R. Endoscopic biliary therapy using the combined percutaneous and endoscopic technique. Gastroenterology. 1989; 96 (4): 1180–1186. https://doi.org/10.1016/0016-5085(89)91639-9
38. Kwon A.H., Uetsuji S., Ogura T., Kamiyama Y. Spiral computed tomography scanning after intravenous infusion cholangiography for biliary duct anomalies. Am. J. Surg. 1997; 174 (4): 396–401; discussion 401–402.
39. De Palma G.D., Galloro G., Siciliano S., Iovino P., Catanzano C. Unilateral versus bilateral endoscopic hepatic duct drainage in patients with malignant hilar biliary obstruction: results of a prospective, randomized, and controlled study. Gastrointest. Endosc. 2001; 53 (6): 547–553. https://doi.org/10.1067/mge.2001.113381
40. Chang W.H., Kortan P., Haber G.B. Outcome in patients with bifurcation tumors who undergo unilateral versus bilateral hepatic duct drainage. Gastrointest. Endosc. 1998; 47 (5): 354–362. https://doi.org/10.1016/s0016-5107(98)70218-4
41. Weickert U., Venzke T., König J., Janssen J., Remberger K., Greiner L. Why do bilio duodenal plastic stents become occluded? A clinical and pathological investigation on 100 consecutive patients. Endoscopy. 2001; 33 (9): 786–790. https://doi.org/10.1055/s-2001-16519
42. Herzog T., Belyaev O., Muller C.A., Mittelkotter U., Seelig M.H., Weyhe D., Felderbauer P., Schlottmann R., Schrader H., Schmidt W.E., Uhl W. Bacteribilia after preoperative bile duct stenting: a prospective study. Clin. Gastroenterol. 2009; 43 (5): 457–462. https://doi.org/10.1097/MCG.0b013e318186b19b
Review
For citations:
Kulezneva J.V., Melekhina O.V., Musatov A.B., Efanov M.G., Tsvirkun V.V., Nedoluzhko I.Yu., Shishin K.V., Salnikov K.K., Kantimerov D.F. Controversial issues of biliary stenting in patients with proximal biliary obstruction. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021;26(3):79-88. (In Russ.) https://doi.org/10.16931/1995-5464.2021-3-79-88