Metal Stents for the Management of Massive Hemobilia in Patients with Hilum-Involving Cholangiocarcinoma Receiving Multi-Regimen Chemotherapy
Recent clinical outcomes of multi-regimen chemotherapy in patients with cholangiocarcinoma (CCC) have shown benefits in terms of overall survival. However, repeated endoscopic biliary drainage (EBD) and serious adverse events negatively affect prolongation of the survival period. The aim of this stu...
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Gastroenterology Council for Gut and Liver
2024-11-01
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| Series: | Gut and Liver |
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| Online Access: | http://gutnliver.org/journal/view.html?doi=10.5009/gnl240087 |
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| author | Seung Yeon Lee Min Je Sung Suk Pyo Shin Hong Jae Chon Beodeul Kang Kwang Hyun Ko Mamoru Takenaka Chang-Il Kwon |
| author_facet | Seung Yeon Lee Min Je Sung Suk Pyo Shin Hong Jae Chon Beodeul Kang Kwang Hyun Ko Mamoru Takenaka Chang-Il Kwon |
| author_sort | Seung Yeon Lee |
| collection | DOAJ |
| description | Recent clinical outcomes of multi-regimen chemotherapy in patients with cholangiocarcinoma (CCC) have shown benefits in terms of overall survival. However, repeated endoscopic biliary drainage (EBD) and serious adverse events negatively affect prolongation of the survival period. The aim of this study was to investigate the prevalence of massive hemobilia and the outcomes of its management with fully covered self-expandable metal stents (FC-SEMSs) in patients with hilum-involving CCC receiving multi-regimen chemotherapy. The methods and effects of FC-SEMS placement were retrospectively investigated following the occurrence of massive hemobilia during EBD. A total of 356 patients with CCC received multi-regimen chemotherapy. Among them, 181 patients had hilar invasion, and seven patients (3.9%) developed massive hemobilia during repeated EBD using removable stents. In all cases, the tumor encased the right hepatic artery. In six patients (85.7%), hemostasis was immediately and completely achieved by inserting one or two FC-SEMSs proximal to the hilar invasion area. Therefore, if the tumor encases the right hepatic artery, massive hemobilia is likely to occur during multi-regimen chemotherapy. Thus, prompt placement of a FC-SEMS would be an effective treatment option for massive hemobilia in patients with hilum-involving CCC. |
| format | Article |
| id | doaj-art-0750e0cf947c4a45b064a6ba72006307 |
| institution | Kabale University |
| issn | 1976-2283 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Gastroenterology Council for Gut and Liver |
| record_format | Article |
| series | Gut and Liver |
| spelling | doaj-art-0750e0cf947c4a45b064a6ba720063072024-11-15T06:27:52ZengGastroenterology Council for Gut and LiverGut and Liver1976-22832024-11-011861085108910.5009/gnl240087gnl240087Metal Stents for the Management of Massive Hemobilia in Patients with Hilum-Involving Cholangiocarcinoma Receiving Multi-Regimen ChemotherapySeung Yeon Lee0Min Je Sung1Suk Pyo Shin2Hong Jae Chon3Beodeul Kang4Kwang Hyun Ko5Mamoru Takenaka6Chang-Il Kwon7Digestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, KoreaDigestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, KoreaDigestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, KoreaDepartment of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, KoreaDepartment of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, KoreaDigestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, KoreaDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osakasayama, JapanDigestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, KoreaRecent clinical outcomes of multi-regimen chemotherapy in patients with cholangiocarcinoma (CCC) have shown benefits in terms of overall survival. However, repeated endoscopic biliary drainage (EBD) and serious adverse events negatively affect prolongation of the survival period. The aim of this study was to investigate the prevalence of massive hemobilia and the outcomes of its management with fully covered self-expandable metal stents (FC-SEMSs) in patients with hilum-involving CCC receiving multi-regimen chemotherapy. The methods and effects of FC-SEMS placement were retrospectively investigated following the occurrence of massive hemobilia during EBD. A total of 356 patients with CCC received multi-regimen chemotherapy. Among them, 181 patients had hilar invasion, and seven patients (3.9%) developed massive hemobilia during repeated EBD using removable stents. In all cases, the tumor encased the right hepatic artery. In six patients (85.7%), hemostasis was immediately and completely achieved by inserting one or two FC-SEMSs proximal to the hilar invasion area. Therefore, if the tumor encases the right hepatic artery, massive hemobilia is likely to occur during multi-regimen chemotherapy. Thus, prompt placement of a FC-SEMS would be an effective treatment option for massive hemobilia in patients with hilum-involving CCC.http://gutnliver.org/journal/view.html?doi=10.5009/gnl240087hemobiliacholangiocarcinomacholangiopancreatographyendoscopic retrogradehilum |
| spellingShingle | Seung Yeon Lee Min Je Sung Suk Pyo Shin Hong Jae Chon Beodeul Kang Kwang Hyun Ko Mamoru Takenaka Chang-Il Kwon Metal Stents for the Management of Massive Hemobilia in Patients with Hilum-Involving Cholangiocarcinoma Receiving Multi-Regimen Chemotherapy Gut and Liver hemobilia cholangiocarcinoma cholangiopancreatography endoscopic retrograde hilum |
| title | Metal Stents for the Management of Massive Hemobilia in Patients with Hilum-Involving Cholangiocarcinoma Receiving Multi-Regimen Chemotherapy |
| title_full | Metal Stents for the Management of Massive Hemobilia in Patients with Hilum-Involving Cholangiocarcinoma Receiving Multi-Regimen Chemotherapy |
| title_fullStr | Metal Stents for the Management of Massive Hemobilia in Patients with Hilum-Involving Cholangiocarcinoma Receiving Multi-Regimen Chemotherapy |
| title_full_unstemmed | Metal Stents for the Management of Massive Hemobilia in Patients with Hilum-Involving Cholangiocarcinoma Receiving Multi-Regimen Chemotherapy |
| title_short | Metal Stents for the Management of Massive Hemobilia in Patients with Hilum-Involving Cholangiocarcinoma Receiving Multi-Regimen Chemotherapy |
| title_sort | metal stents for the management of massive hemobilia in patients with hilum involving cholangiocarcinoma receiving multi regimen chemotherapy |
| topic | hemobilia cholangiocarcinoma cholangiopancreatography endoscopic retrograde hilum |
| url | http://gutnliver.org/journal/view.html?doi=10.5009/gnl240087 |
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