Unilateral drainage and chemotherapy prolong the patency of a plastic stent placed above the sphincter of Oddi in patients with malignant hilar biliary obstruction

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY

DEN open Pub Date : 2024-07-15 DOI:10.1002/deo2.404

Fumimasa Tomooka, Koh Kitagawa, Akira Mitoro, Yukihisa Fujinaga, Norihisa Nishimura, Tadashi Namisaki, Takemi Akahane, Kosuke Kaji, Shohei Asada, Shinya Sato, Jun-Ichi Hanatani, Hitoshi Mori, Yuki Motokawa, Tomihiro Iwata, Hiroki Kachi, Yui Osaki, Hitoshi Yoshiji

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Abstract

Objectives

To evaluate the results of inside stent therapy for unresectable malignant hilar biliary obstruction and identify factors related to stent patency duration.

Methods

Of 44 patients who underwent initial inside-stent placement above the sphincter of Oddi from April 2017 to December 2022, 42 with the resolution of jaundice (clinical success rate, 95.5%) were retrospectively analyzed. Univariate and multivariate logistic regression analysis identified factors associated with stent patency duration.

Results

Univariate analysis revealed significant differences in the drainage method (406 days for unilateral drainage vs. 305 days for bilateral drainage of the right and left liver lobes, p = 0.022) with or without chemotherapy (406 days with vs. 154 days without, p = 0.038). Multivariate analysis (Cox proportional hazards analysis) revealed similar results, with unilateral drainage (p = 0.031) and chemotherapy (p = 0.048) identified as independent factors associated with prolonged stent patency. Early adverse events were observed in two patients (4.8%; one cholangitis, one pancreatitis).

Conclusions

Inside-stent therapy was safely performed in patients with malignant hilar biliary obstruction. Simple unilateral drainage and chemotherapy may prolong stent patency.

Abstract Image

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单侧引流和化疗可延长放置在恶性胆道梗阻患者奥奇括约肌上方的塑料支架的通畅时间。

目的评估内支架治疗不可切除恶性胆道梗阻的效果，并确定与支架通畅时间相关的因素：回顾性分析2017年4月至2022年12月期间在Oddi括约肌上方接受初次内支架置入术的44例患者，其中42例患者的黄疸得到缓解（临床成功率为95.5%）。单变量和多变量逻辑回归分析确定了与支架通畅时间相关的因素：单变量分析显示，引流方法（单侧引流 406 天 vs. 左右肝叶双侧引流 305 天，p = 0.022）与化疗或不化疗（化疗 406 天 vs. 不化疗 154 天，p = 0.038）之间存在显著差异。多变量分析（Cox比例危险分析）显示了类似的结果，单侧引流（p = 0.031）和化疗（p = 0.048）被认为是延长支架通畅时间的独立相关因素。两名患者（4.8%；一名胆管炎，一名胰腺炎）出现了早期不良反应：结论：恶性肝胆道梗阻患者可以安全地接受内支架治疗。简单的单侧引流和化疗可延长支架的通畅时间。

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

DEN open

CiteScore

1.30

自引率

0.00%

发文量