Risk factors for recurrent biliary obstruction following endoscopic biliary stenting in patients with unresectable ampullary cancer: A multicenter retrospective study

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases Pub Date : 2024-06-20 DOI:10.1111/1751-2980.13288

Ryo Sugiura, Masaki Kuwatani, Toshifumi Kin, Ryusuke Matsumoto, Yuki Ikeda, Itsuki Sano, Koji Hirata, Makoto Yoshida, Yoshiharu Masaki, Michihiro Ono, Hajime Hirata, Hiroaki Yamato, Manabu Onodera, Hideaki Nakamura, Yoko Taya, Nobuyuki Ehira, Masahito Nakajima, Hidemasa Kawabata, Hideyuki Ihara, Taiki Kudo, Shin Kato, Akio Katanuma, Hokkaido Interventional EUS/ERCP study (HONEST) group

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引用次数: 0

Abstract

Objectives

Unresectable ampullary cancer (AC) is a rare disease entity. The risk factors for recurrent biliary obstruction (RBO) following endoscopic biliary stenting (EBS) for unresectable AC remain unknown. In this study we aimed to evaluate the cumulative RBO rate and to identify risk factors for RBO following palliative EBS in patients with unresectable AC.

Methods

This multicenter retrospective observational study enrolled consecutive patients with unresectable AC who had undergone palliative EBS between April 2011 and December 2021. The cumulative rate of and risk factors for RBO following palliative EBS were evaluated via multivariate analysis.

Results

The study analysis comprised 107 patients with a median age of 84 years (interquartile range 79–88 years). Plastic stents (PSs) and self-expandable metal stents (SEMSs) were placed in 53 and 54 patients, respectively. Functional success was accomplished in 104 (97.2%) patients. Of these, RBO occurred in 62 (59.6%) patients, with obstruction and complete/partial migration occurring in 47 and 15 patients, respectively. The median time to RBO was 190 days. Multivariate analysis showed that PS was associated with a higher rate of RBO compared to SEMS (hazard ratio [HR] 2.48; P < 0.01) and that the presence of common bile duct stones/sludge immediately after EBS was an independent risk factor for RBO (HR 1.99; P = 0.04).

Conclusions

The use of SEMS compared to PS during EBS reduced the time to RBO in patients with unresectable AC. Common bile duct stones/sludge immediately after EBS was a risk factor for RBO.

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无法切除的膀胱癌患者接受内镜胆道支架术后复发胆道梗阻的风险因素：一项多中心回顾性研究。

目的：无法切除的膀胱癌（AC）是一种罕见疾病。对无法切除的胰腺癌患者进行内镜胆道支架置入术（EBS）后出现复发性胆道梗阻（RBO）的风险因素仍不清楚。在这项研究中，我们旨在评估不可切除性 AC 患者接受姑息性 EBS 治疗后的累积 RBO 发生率，并确定 RBO 的风险因素：这项多中心回顾性观察研究招募了2011年4月至2021年12月期间接受姑息性EBS治疗的连续性不可切除前房动脉粥样硬化患者。通过多变量分析评估了姑息性 EBS 术后 RBO 的累积发生率和风险因素：研究分析包括107名患者，中位年龄为84岁（四分位距为79-88岁）。分别为 53 名和 54 名患者放置了塑料支架（PS）和自膨胀金属支架（SEMS）。104例（97.2%）患者获得了功能性成功。其中，62 例（59.6%）患者发生了 RBO，阻塞和完全/部分移位分别发生在 47 例和 15 例患者中。发生 RBO 的中位时间为 190 天。多变量分析显示，与SEMS相比，PS与更高的RBO发生率相关（危险比[HR] 2.48；P 结论：与PS相比，SEMS与更高的RBO发生率相关：与 PS 相比，在 EBS 期间使用 SEMS 缩短了不可切除 AC 患者发生 RBO 的时间。EBS后立即使用胆总管结石/淤积是导致RBO的危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Digestive Diseases 医学-胃肠肝病学

CiteScore

5.40

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Digestive Diseases is the official English-language journal of the Chinese Society of Gastroenterology. The journal is published twelve times per year and includes peer-reviewed original papers, review articles and commentaries concerned with research relating to the esophagus, stomach, small intestine, colon, liver, biliary tract and pancreas.