Placement of a newly designed partially covered T- or Y-configured self-expanding metallic stent for hilar biliary obstruction: technical note

Purpose To investigate the technical success, efficacy, and safety of a newly designed partially covered bilateral self-expanding metallic stent (SEMS) in patients with malignant biliary obstruction. Material and methods From May 2016 to November 2017, ten patients with malignant hilar biliary stenosis (bismuth type II–IV) underwent stent placement with the newly designed partially covered T/Y-configured SEMS. Technical success, drainage catheter removal, jaundice remission, early and late complications, stent patency, and overall survival were analyzed. Results The stent was successfully deployed in all patients. The total bilirubin level significantly decreased one month after stent placement ( P < 0.05). Drainage catheter removal rate was 90%. Two cases (20%) experienced early complications (bile duct hemorrhage and cholangitis) and two cases (20%) experienced late complications (hepatic abscess and cholangitis). During the follow-up (mean 276 days; range 57–503 days) stent occlusion occurred in three patients (30%), and two patents died of hepatic failure. The median stent patency and overall survival were 275 days (95% CI 223.8–326.3 days) and 428.9 days (95% CI 347.9–509.8 days), respectively. Conclusion The newly designed partially covered T/Y-configured SEMS is technically feasible and clinically effective for biliary trifurcation obstruction.