Background: Although endoscopic stent placement is now generally accepted as a palliative method of treatment in unresectable hilar cholangiocarcinoma, exclusively endoscopic placement of bilateral metal stents has been considered very difficult and complex.
Objective: To evaluate the technical and clinical efficacy of endoscopic placement of dual, newly designed stents in a Y configuration.
Design: Prospective, uncontrolled, single center.
Setting: Tertiary referral university hospital.
Patients: Ten patients with unresectable hilar cholangiocarcinoma of Bismuth type II or higher.
Interventions: For bilateral metal stent placement, a biliary Y stent with central wide-open mesh was used exclusively at first. A second stent was placed into the contralateral hepatic duct through the central open mesh of the Y stent.
Main outcome measurement: Technical success, functional success, early complications, and short-term clinical outcome.
Results: Technical success was achieved in 8 of 10 patients (80%). Among 8 patients in whom bilateral stents were successfully placed by endoscopy, functional success was 100%, the early complication rate was 0%, and the stent occlusion rate was 25%. The median stent patency period was 217 days.
Limitations: Small number of patients, uncontrolled study, short-term follow-up period.
Conclusions: We described a technique for endoscopic bilateral metal stent placement by using the newly designed Y stent for advanced hilar cholangiocarcinoma that resulted in a high success rate of 80%.