Risk Factors Associated with Recurrent Biliary Obstruction After Endoscopic Bilioduodenal Double Stenting.

IF 2.8 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Digestive Diseases and Sciences Pub Date : 2026-11-01 Epub Date: 2026-07-08 DOI:10.1007/s10620-026-10100-x

Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Hiroyuki Asama, Hiroshi Shimizu, Kentaro Sato, Kento Osawa, Rei Ohira, Jun Nakamura, Tsunetaka Kato, Takumi Yanagita, Mitsuru Otsuka, Takuto Hikichi, Hiromasa Ohira

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引用次数: 0

Abstract

Objective: Endoscopic bilioduodenal double stenting is sometimes necessary for patients with malignant bilioduodenal obstruction (MBDO). The patency of biliary stents is important for preventing cholangitis and continuing treatment. However, the factors that influence recurrent biliary obstruction (RBO) in patients with MBDO are not well known. This study aimed to identify the factors associated with RBO in patients who underwent endoscopic bilioduodenal double stenting.

Methods: Patient characteristics, device use, and endoscopic treatment procedures were evaluated as possible risk factors for RBO.

Results: Overall, 55 patients with MBDO underwent endoscopic bilioduodenal double stenting (transpapillary drainage, n = 35; endoscopic ultrasound-guided biliary drainage, n = 20). Multivariate analysis using a Fine and Gray competing risk model revealed that biliary stenting on the oral side of the duodenal stricture (HR 2.98; 95% CI 1.16-7.68; p = 0.023) and chemotherapy (HR 3.74; 95% CI 1.25-11.22; p = 0.018) were significantly associated with RBO.

Conclusion: Biliary stenting on the oral side of the duodenal stricture was associated with RBO during duodenal stenting in patients with MBDO. Although chemotherapy was also associated with RBO in the multivariable competing risk analysis, this finding should be interpreted cautiously. Careful treatment selection, including consideration of gastrojejunostomy in patients with oral-side biliary stenting, may help reduce the incidence of RBO.

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内镜下胆十二指肠双支架置入术后复发性胆道梗阻的相关危险因素。

目的：内镜下胆十二指肠双支架植入术治疗恶性胆十二指肠梗阻（MBDO）是必要的。胆道支架通畅对预防胆管炎和继续治疗具有重要意义。然而，影响MBDO患者复发性胆道阻塞（RBO）的因素尚不清楚。本研究旨在确定内镜下胆十二指肠双支架植入术患者发生RBO的相关因素。方法：评估患者特征、器械使用和内镜治疗程序作为RBO可能的危险因素。结果：总体而言，55例MBDO患者接受了内镜下胆道十二指肠双支架植入术（经毛细血管引流，n = 35；内镜下超声引导胆道引流，n = 20）。使用Fine和Gray竞争风险模型的多变量分析显示，在十二指肠狭窄的口腔一侧胆道支架植入术（HR 2.98; 95% CI 1.16-7.68; p = 0.023）和化疗（HR 3.74; 95% CI 1.25-11.22; p = 0.018）与RBO显著相关。结论：MBDO患者在十二指肠狭窄口侧行胆道支架置入与RBO相关。虽然在多变量竞争风险分析中化疗也与RBO相关，但这一发现应谨慎解释。谨慎的治疗选择，包括考虑对经口侧胆道支架植入术患者进行胃空肠吻合术，可能有助于减少RBO的发生率。

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

Digestive Diseases and Sciences 医学-胃肠肝病学

CiteScore

6.40

自引率

3.20%

发文量

420

审稿时长

1 months

期刊介绍： Digestive Diseases and Sciences publishes high-quality, peer-reviewed, original papers addressing aspects of basic/translational and clinical research in gastroenterology, hepatology, and related fields. This well-illustrated journal features comprehensive coverage of basic pathophysiology, new technological advances, and clinical breakthroughs; insights from prominent academicians and practitioners concerning new scientific developments and practical medical issues; and discussions focusing on the latest changes in local and worldwide social, economic, and governmental policies that affect the delivery of care within the disciplines of gastroenterology and hepatology.