Cross-Wired Metallic Stents In Endoscopic Bilateral Stent-In-Stent Placement For Malignant Hilar Biliary Obstruction

Whether unilateral or bilateral drainage should be performed for malignant hilar biliary obstruction is controversial. Endoscopic bilateral metallic stent placement in a stent-in-stent (SIS) method for malignant hilar biliary obstruction is technically difficult. Open cell-design metal stents have a high technical success rate in SIS placement. Cross-wired metallic stents (BONASTENTR M-Hilar; Standard Sci Tech) have a conventional hook and cross-wired structure on the proximal and distal portions. However, on the 25-mm-long central portion, this stent only has a cross-wired structure to facilitate placement of a contralateral stent across it. This study evaluated the technical feasibility and clinical efficacy of endoscopic bilateral SIS placement of cross-wired metallic stents in malignant hilar biliary obstruction.