Stenting

Management of strictures related to pancreaticobiliary disease continues to be an area of exploration and opportunity for treating both malignant and benign disease. Dilation and stenting of strictures helps patients maintain nutrition often while undergoing neoadjuvent treatment. This web page is intended to provide an venue to share clinical data, case studies and perspectives on biliary stenting from experts in the field to educate other physicians interested in advanced pancreaticobiliary disease management.

Presentation on Stent Management

Video

Biliary Metal Stenting Strategies for Malignant Biliary Obstruction, Hiroyuki Isayama, M.D., PhD

Dr. Hiroyuki Isayama from Juntendo University in Tokyo, Japan discusses procedural strategies, situational stent selection and clinical evidence to help manage strictures.

Video

Staging, Treatment Sequencing, and Personalized Medicine for Localized Pancreatic Cancer: The Medical College of Wisconsin Experience, Douglas B. Evans, MD

A surgeon’s perspective on the unique challenges of pancreatic cancer. Dr. Evans presents clinical data assessing different approaches to staging, treatment and management.

Set-up and Use Turorials

Video

Epic™ Biliary Endoscopic Stent System Device Tutorial

This video provides a step-by-step tutorial on the set up and deployment of the Epic Biliary Stent System.

Video

Performing ERCP with Stent Placement and Cholangioscopy by Neil Sharma, M.D., Fort Wayne, Indiana, U.S.A.

Using the SpyGlass™ DS System, biliary stones are identified and removed, and targeted biopsies are performed where cholangiocarcinoma is suspected. Once a diagnosis of benign ductal cells is confirmed, a plastic stent is placed.

Video

WallFlex™ Biliary RX Stent In-service, by Thomas Kowalski, MD

Dr. Kowalski provides a step-by-step demonstration of set-up and deployment of a WallFlex Biliary RX Stent.

Animations

Video

Procedural Animation: WallFlex Biliary RX Stent

This animation includes the steps for placement and deployment of a WallFlex Biliary RX Stent.

Video

Procedural Animation: Advanix™ Biliary Stent with NaviFlex™ RX Delivery System

This animation highlights the features of the Advanix Biliary Stent with NaviFlex™ RX Delivery System as well as the steps for placement and deployment.

Written Case Studies

Document

Utility of Side-by-Side 6Fr Biliary Metal Stent Placement for a Malignant Biliary Obstruction, Meir Mizrahi, MD

Document

Simultaneous SEMS Placement for Unresectable Malignant Hilar Biliary Obstruction Presented by Gulshan Parasher, MD and Thomas C. Queen, MD

Document

Single-balloon Enteroscopy-assisted ERCP for Altered Anatomy or Long-limb ERCP Procedures: Persistent Distal CBD Stricture with Marked Dilation of the Upstream Ducts and Friable GI Mucosa

Document

Successful Biliary Drainage in a Benign Common Bile Duct Stricture Due to Chronic Pancreatitis, presented by Jesús García-Cano, M.D., Ph.D.

Document

Placing a Pancreatic Plastic Stent to Drain the Pancreatic Duct, presented by Mankanwal Singh Sachdev, M.D

Document

Treatment of Suspected Neoplastic Stricture in the Right Hepatic Duct with a 6mm Metal Stent, presented by Urban Arnelo MD, PhD.

Warning: The safety and effectiveness of biliary metal stents for use in the vascular system has not been established.

Results from case studies may vary. Results from case studies are not predictive of results in other case studies.

INDICATIONS FOR USE in the United States:

The WallFlex Biliary RX Fully Covered Stent System RMV is indicated for use in the palliative treatment of biliary strictures produced by malignant neoplasms, relief of malignant biliary obstruction prior to surgery and for indwell up to 12 months in the treatment of benign biliary strictures secondary to chronic pancreatitis.
LIMITATIONS
The sale, distribution, and use of the device are restricted to prescription use inaccordance with 21 CFR §801.109
Contraindications:
• The WallFlex Biliary RX Fully Covered Stent should not be placed in strictures that cannot be dilated enough to pass the delivery system, in a perforated duct, or in very small intrahepatic ducts.
• The WallFlex Biliary RX Fully Covered Stent System RMV should not be used in patients for whom endoscopic techniques are contraindicated.
Warnings: The safety and effectiveness of the stent has not been established for indwell periods exceeding 12 months. The WallFlex Biliary RX Fully Covered Stent System RMV is for single-use only. The safety and effectiveness of the WallFlex Biliary RX Fully Covered Stent System RMV for use in the vascular system has not been established. The safety and effectiveness of the WallFlex Biliary RX Fully Covered Stent System RMV has not been established in the treatment of benign biliary anastomotic strictures in liver transplant patients and benign biliary post abdominal surgery strictures. Testing of overlapped stents has not been conducted. The stent contains nickel, which may cause an allergic reaction in individuals with nickel sensitivity.
PLEASE REFER TO THE LABELING FOR A MORE COMPLETE LIST OF WARNINGS, PRECAUTIONS AND CONTRAINDICATIONS