单侧和双侧导管内塑料支架置入治疗不可切除的恶性肝门胆道梗阻的比较:倾向评分匹配队列分析。

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Mitsuru Okuno, Keisuke Iwata, Tsuyoshi Mukai, Yuhei Iwasa, Shinya Uemura, Kensaku Yoshida, Akinori Maruta, Takuji Iwashita, Ichiro Yasuda, Masahito Shimizu
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引用次数: 0

摘要

背景:虽然导管内塑料支架(IS)放置是一种有效的治疗不可切除的恶性肝门胆道梗阻(UMHBO)的方法,但单侧和双侧IS引流的有效性仍然存在争议。本回顾性研究使用倾向评分匹配法调查双侧IS放置UMHBO的有效性。方法:对接受UMHBO经毛细血管内窥镜支架植入术的患者进行技术和临床成功、不良事件和复发性胆道梗阻(TRBO)时间的分析。结果:共有321例患者入组,在基于倾向评分的队列中,单侧和双侧IS组各27例患者。单侧和双侧IS组技术成功率为100%,临床成功率分别为93%和96% (p = 1.0)。胆囊炎发生率分别为4%和7% (p = 1.0)。单侧组的中位TRBO(129[5-383]天)短于双侧组(226[16-563]天)(p = 0.0281)。双侧IS放置是独立的长TRBO因素(风险比[HR] 0.46;95%置信区间[CI]: 0.21-0.97;p = .041)。结论:单侧和双侧IS置入术在初次支架置入术中具有较高的技术和临床成功率。然而,双侧IS放置显示较长的TRBO。双侧IS放置可能是初始UMHBO引流的好选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Comparison of unilateral and bilateral intraductal plastic stent placement for unresectable malignant hilar biliary obstruction: A propensity score-matched cohort analysis

Comparison of unilateral and bilateral intraductal plastic stent placement for unresectable malignant hilar biliary obstruction: A propensity score-matched cohort analysis

Background

Although intraductal plastic stent (IS) placement is an effective treatment for unresectable malignant hilar biliary obstruction (UMHBO), the effectiveness of unilateral and bilateral IS drainage remains controversial. This retrospective study investigated the effectiveness of bilateral IS placement for UMHBO using the propensity score matching method.

Methods

Patients who underwent transpapillary endoscopic stenting for UMHBO were analyzed for technical and clinical success, adverse events, and time to recurrent biliary obstruction (TRBO).

Results

A total of 321 patients were enrolled in the study with 27 patients in each unilateral and bilateral IS group in the propensity score-based cohort. Technical success was 100%, while clinical success was 93% and 96% in the unilateral and bilateral IS groups, respectively (p = 1.0). Cholecystitis occurred in 4% and 7%, respectively (p = 1.0). The median TRBO was shorter in the unilateral group (129 [5–383] days) than that in the bilateral group (226 [16–563] days) (p = .0281). Bilateral IS placement was an independent long TRBO factor (hazard ratio [HR] 0.46; 95% confidence interval [CI]: 0.21–0.97; p = .041).

Conclusions

Unilateral and bilateral IS placement had high technical and clinical success rates in primary stent placement. However, bilateral IS placement showed a longer TRBO. Bilateral IS placement may be a good option for initial UMHBO drainage.

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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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