Breaking the barrier too: Fully covered self-expandable metal stents placed across the bifurcation in the management of malignant hilar obstruction

摘要

I read with interest about the placement of fully covered self-expandable metal stents (FCSEMSs) across the bifurcation for benign hilar strictures. Placement of covered self-expandable metal stents across the bifurcation is considered contraindicated because it may occlude the contralateral system and/or intrahepatic branches. I report on FCSEMSs placed across the bifurcation in cholangio-carcinoma (CCA).A 60-year-old female patient with unresectable tissue-proven hilar CCA, jaundice, and atrophy of the left system underwent unilateral right intrahepatic plastic stent placement. Stent occlusion occurred after 8 weeks or less. A FCSEMS (Viabil, W.L. Gore, Flagstaff, Ariz) was placed across the bifurcation into the right hepatic duct below the right anterior and posterior ducts (Fig. 1).