Feasibility of one-step endoscopic metal stenting for distal malignant biliary obstruction

被引：3

作者：

Shimizu, Shuya ^{[1
]}

Naitoh, Itaru ^{[1
]}

Nakazawa, Takahiro ^{[1
]}

Hayashi, Kazuki ^{[1
]}

Miyabe, Katsuyuki ^{[1
]}

Kondo, Hiromu ^{[1
]}

Yoshida, Michihiro ^{[1
]}

Yamashita, Hiroaki ^{[1
]}

Ohara, Hirotaka ^{[2
]}

Joh, Takashi ^{[1
]}

机构：

[1] Nagoya City Univ, Grad Sch Med Sci, Dept Gastroenterol & Metab, Mizuho Ku, Nagoya, Aichi 4678601, Japan

[2] Nagoya City Univ, Grad Sch Med Sci, Dept Community Based Med Educ, Nagoya, Aichi 4678601, Japan

来源：

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES | 2014年 / 21卷 / 03期

关键词：

Distal malignant biliary obstruction; One-step; Self-expandable metal stent; Two-step; HIGH-RISK PATIENTS; COMMON BILE-DUCT; COMPUTED-TOMOGRAPHY; FORCEPS BIOPSY; RETROGRADE CHOLANGIOPANCREATOGRAPHY; PREOPERATIVE EVALUATION; PANCREATIC-CANCER; CONTROLLED-TRIAL; BRUSH CYTOLOGY; PLACEMENT;

D O I：

10.1002/jhbp.22

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BackgroundWe aimed to clarify the clinical usefulness of one-step self-expandable metal stent (SEMS) placement for distal malignant biliary obstruction by comparing with two-step SEMS placement. MethodsWe retrospectively compared early complications, bilirubin level decreasing rate, and period of hospitalization between 40 patients with one-step SEMS and 52 patients with two-step SEMS. We also evaluated the complications in patients with two-step SEMS by classifying them into first drainage (ERBD or ENBD) and second drainage (SEMS). ResultsThe total incidence of early complications was significantly higher in patients with one-step SEMS than the second drainage of two-step SEMS (42.5% [17/40] vs. 13.5% [7/52]; P=0.004). However, there was no significant difference in the early complications between one-step SEMS and two-step SEMS (total of first and second drainage) (42.5% [17/40] vs. 36.5% [19/52]; P=0.561). The period required to reach the bilirubin level (<3mg/dL) after initial drainage was significantly shorter in one-step SEMS than in two-step SEMS (5.7 vs. 10.1 days; P=0.025). Similar results were observed in the period of hospitalization for patients without chemotherapy (22.2 vs. 37.3 days; P=0.004). ConclusionsOne-step SEMS placement is the alternative option of drainage method for distal malignant biliary obstruction.

引用

页码：219 / 225

页数：7

共 32 条

[1] No Benefit of Covered vs Uncovered Self-Expandable Metal Stents in Patients With Malignant Distal Biliary Obstruction: A Meta-analysis [J].