Adverse events of self-expandable metal stent placement for malignant distal biliary obstruction: a large multicenter study

被引：7

作者：

Tamura, Takashi ^{[1
]}

Yamai, Takuo ^{[2
]}

Uza, Norimitsu ^{[3
]}

Yamasaki, Tomoaki ^{[4
]}

Masuda, Atsuhiro ^{[5
]}

Tomooka, Fumimasa ^{[6
]}

Maruyama, Hirotsugu ^{[7
]}

Shigekawa, Minoru ^{[8
]}

Ogura, Takeshi ^{[9
]}

Kuriyama, Katsutoshi ^{[10
]}

Asada, Masanori ^{[11
]}

Matsumoto, Hisakazu ^{[12
]}

Takenaka, Mamoru ^{[13
]}

Mandai, Koichiro ^{[14
]}

Osaki, Yui ^{[15
]}

Matsumoto, Kengo ^{[16
]}

Sanuki, Tsuyoshi ^{[17
]}

Shiomi, Hideyuki ^{[18
]}

Yamagata, Yosuke ^{[19
]}

Doi, Toshifumi ^{[20
]}

Inatomi, Osamu ^{[21
]}

Nakanishi, Fumihiko ^{[22
]}

Emori, Tomoya ^{[23
]}

Shimatani, Masaaki ^{[24
]}

Asai, Satoshi ^{[25
]}

Fujigaki, Seiji ^{[26
]}

Shimokawa, Toshio ^{[27
]}

Kitano, Masayuki ^{[1
,28
]}

机构：

[1] Wakayama Med Univ, Dept Internal Med 2, Wakayama, Japan

[2] Osaka Int Canc Inst, Dept Hepatobiliary & Pancreat Oncol, Osaka, Japan

[3] Kyoto Univ, Grad Sch Med, Dept Gastroenterol & Hepatol, Kyoto, Japan

[4] Osaka City Gen Hosp, Dept Gastroenterol, Osaka, Japan

[5] Kobe Univ, Dept Internal Med, Grad Sch Med, Div Gastroenterol, Hyogo, Japan

[6] Nara Med Univ, Dept Gastroenterol, Nara, Japan

[7] Osaka Metropolitan Univ, Dept Gastroenterol, Grad Sch Med, Osaka, Japan

[8] Osaka Univ, Dept Gastroenterol & Hepatol, Grad Sch Med, Osaka, Japan

[9] Osaka Med & Pharmaceut Univ Hosp, Endoscop Ctr, Osaka, Japan

[10] Kitano Hosp, PIIF Tazuke Kofukai, Dept Gastroenterol & Hepatol, Med Res Inst, Osaka, Japan

[11] Japanese Red Cross Osaka Hosp, Dept Gastroenterol & Hepatol, Osaka, Japan

[12] Japanese Red Cross Wakayama Med Ctr, Gastroenterol & Hepatol, Wakayama, Japan

[13] Kindai Univ, Dept Gastroenterol & Hepatol, Fac Med, Osaka, Japan

[14] Kyoto Second Red Cross Hosp, Dept Gastroenterol, Kyoto, Japan

[15] Nara Prefecture Seiwa Med Ctr, Dept Gastroenterol, Nara, Japan

[16] Toyonaka City Hosp, Dept Gastroenterol, Toyonaka, Osaka, Japan

[17] Kita harima Med Ctr, Dept Gastroenterol, Hyogo, Japan

[18] Hyogo Med Univ, Dept Internal Med, Div Gastroenterol & Hepatobiliary & Pancreat Dis, Nishinomiya, Hyogo, Japan

[19] Yodogawa Christians Hosp, Dept Gastroenterol & Hepatol, Osaka, Japan

[20] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Mol Gastroenterol & Hepatol, Kamigyo ku, Kyoto, Japan

[21] Shiga Univ Med Sci, Dept Med, Div Gastroenterol, Otsu, Shiga, Japan

[22] Natl Hosp Org Osaka, Minami Med Ctr, Dept Gastroenterol, Kawachi Nagano, Osaka, Japan

[23] Wakayama Rosai Hosp, Dept Gastroenterol, Wakayama, Japan

[24] Kansai Med Univ, Div Gastroenterol & Hepatol, Med Ctr, Moriguchi, Osaka, Japan

[25] Tane Gen Hosp, Dept Gastroenterol, Osaka, Japan

[26] Steel Mem Hirohata Hosp, Dept Gastroenterol, Himeji, Hyogo, Japan

[27] Wakayama Med Univ Hosp, Clin Study Support Ctr, Wakayama, Japan

[28] Wakayama Med Univ, Dept Internal Med 2, 811-1 Kimiidera, Wakayama, Wakayama 6418509, Japan

来源：

GASTROINTESTINAL ENDOSCOPY | 2024年 / 99卷 / 01期

关键词：

RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS; RISK-FACTORS; ENDOSCOPIC SPHINCTEROTOMY; CHOLECYSTITIS; ERCP; COMPLICATIONS; PREVENTION; MIGRATION; INSERTION; EFFICACY;

D O I：

10.1016/j.gie.2023.08.004

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and Aims: Endoscopic placement of self -expandable metal stents (SEMSs) for malignant distal biliary obstruction (MDBO) may be accompanied by several types of adverse events. The present study analyzed the adverse events occurring after SEMS placement for MDBO. Methods: The present study retrospectively investigated the incidence and types of adverse events in patients who underwent SEMS placement for MDBO between April 2018 and March 2021 at 26 hospitals. Risk factors for acute pancreatitis, cholecystitis, and recurrent biliary obstruction (RBO) were evaluated by univariate and multivariate analyses. Results: Of the 1425 patients implanted with SEMSs for MDBO, 228 (16.0%) and 393 (27.6%) experienced early adverse events and RBO, respectively. Pancreatic duct without tumor involvement (P = .023), intact papilla (P = .025), and SEMS placement across the papilla (P = .037) were independent risk factors for acute pancreatitis. Tumor involvement in the orifice of the cystic duct was an independent risk factor for cholecystitis (P < .001). Use of fully and partially covered SEMSs was an independent risk factor for food impaction and/or sludge. Use of fully covered SEMSs was an independent risk factor for stent migration. Use of uncovered SEMSs and lasercut SEMSs was an independent risk factor for tumor ingrowth. Conclusions: Pancreatic duct without tumor involvement, intact papilla, and SEMS placement across the papilla were independent risk factors for acute pancreatitis, and tumor involvement in the orifice of the cystic duct was an independent risk factor for cholecystitis. The risk factors for food impaction and/or sludge, stent migration, and tumor ingrowth differed among types of SEMSs.

引用

页码：61 / 72.e8

页数：20

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