Objectives: Early obstruction of a self-expandable metal stent placed for distal malignant biliary obstruction is more likely to occur in the presence of duodenal invasion. An anti-reflux self-expandable metal stent (ARMS) has been developed for the purpose of preventing duodenal fluid reflux into the bile duct. In this study, we evaluated the usefulness and safety of a duckbill-type ARMS (D-ARMS) in the situation of duodenal invasion.
Methods: We retrospectively analyzed 10 consecutive patients who received D-ARMS for distal malignant biliary obstruction with duodenal invasion. We evaluated non-occlusion cholangitis, recurrent biliary obstruction (RBO), and adverse events after D-ARMS placement.
Results: There were no cases of non-occlusion cholangitis. RBO was observed in 2 patients (20%), and time to RBO was 236 days and 117 days, respectively. The causes of RBO were overgrowth and sludge formation. The median time to RBO was 382 days (range, 117-382 days). Only one adverse event was observed (cholecystitis).
Conclusions: D-ARMS shows potential as an optimal ARMS.
Keywords: cholangiopancreatography; common bile duct; endoscopic retrograde; self‐expandable metallic stents.
© 2022 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.