A retrospective study assessing fully covered metal stents as first-line management for malignant biliary strictures

被引：14

作者：

Sampaziotis, Fotios ^{[1
,3
]}

Elias, Joshua ^{[2
]}

Gelson, William T. H. ^{[1
]}

Gimson, Alexander E. ^{[1
]}

Griffiths, William J. H. ^{[1
]}

Woodward, Jeremy ^{[2
]}

Shariff, Mohamed ^{[4
]}

Macfarlane, Bruce ^{[4
]}

King, Alistair ^{[4
]}

Corbett, Gareth ^{[2
]}

Leahy, Anthony ^{[4
]}

机构：

[1] Univ Cambridge, Dept Hepatol, Hosp NHS Fdn Trust, Cambridge, England

[2] Univ Cambridge, Dept Gastroenterol, Hosp NHS Fdn Trust, Cambridge, England

[3] Univ Cambridge, Wellcome Trust Med Res Council Stem Cell Inst, Dept Surg, Anne McLaren Lab Regenerat Med, Cambridge, England

[4] West Hertfordshire Hosp NHS Trust, Dept Gastroenterol, Watford, Herts, England

来源：

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY | 2015年 / 27卷 / 11期

关键词：

complications; distal malignant biliary strictures; fully covered self-expanding metal stents; patency; survival;

D O I：

10.1097/MEG.0000000000000455

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objectives Fully covered self-expanding metal stents (FCSEMS) constitute the first type of metal stent that can easily be removed endoscopically and/or intraoperatively, which may be advantageous in the management of distal malignant biliary strictures (DMBS). To assess the efficacy of FCSEMS as first-line treatment for DMBS, we compared patency, survival and complication rates between FCSEMS, uncovered self-expanding metal stents (USEMS) and plastic stents (PS). Methods This was a multicentre retrospective study of 315 consecutive patients with DMBS, who underwent endoscopic retrograde cholangiopancreatography and stenting (FCSEMS, USEMS or PS) at two hospitals between 1 January 2007 and 31 December 2013. Stent patency and patient survival were compared using the Kaplan-Meier method; complication rates were compared using Fisher's exact test; and Cox regression analysis was used to screen for confounding factors. Results FCSEMS were associated with prolonged stent patency (median = 145 days) compared with USEMS (median = 110 days, P < 0.003) and PS (median = 34 days, P < 0.001). Biliary sepsis rates were lower for FCSEMS compared with PS (4.7 vs. 17.8%, P = 0.02), whereas pancreatitis rates were higher for FCSEMS compared with USEMS (7.8 vs. 1.0%, P = 0.04), but not PS (2.6%, P = NS). Conclusion The use of FCSEMS as first-line management for DMBS is associated with longer patency and reduced complication rates compared with the use of PS. However, the higher rate of pancreatitis compared with USEMS requires further evaluation in a large randomized controlled trial. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.

引用

页码：1347 / 1353

页数：7

共 31 条

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