{"title":"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。","authors":"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","doi":"10.1002/deo2.404","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To evaluate the results of inside stent therapy for unresectable malignant hilar biliary obstruction and identify factors related to stent patency duration.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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, <i>p</i> = 0.022) with or without chemotherapy (406 days with vs. 154 days without, <i>p</i> = 0.038). Multivariate analysis (Cox proportional hazards analysis) revealed similar results, with unilateral drainage (<i>p</i> = 0.031) and chemotherapy (<i>p</i> = 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).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Inside-stent therapy was safely performed in patients with malignant hilar biliary obstruction. Simple unilateral drainage and chemotherapy may prolong stent patency.</p>\n </section>\n </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11248713/pdf/","citationCount":"0","resultStr":"{\"title\":\"Unilateral drainage and chemotherapy prolong the patency of a plastic stent placed above the sphincter of Oddi in patients with malignant hilar biliary obstruction\",\"authors\":\"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\",\"doi\":\"10.1002/deo2.404\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>To evaluate the results of inside stent therapy for unresectable malignant hilar biliary obstruction and identify factors related to stent patency duration.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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, <i>p</i> = 0.022) with or without chemotherapy (406 days with vs. 154 days without, <i>p</i> = 0.038). Multivariate analysis (Cox proportional hazards analysis) revealed similar results, with unilateral drainage (<i>p</i> = 0.031) and chemotherapy (<i>p</i> = 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).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Inside-stent therapy was safely performed in patients with malignant hilar biliary obstruction. Simple unilateral drainage and chemotherapy may prolong stent patency.</p>\\n </section>\\n </div>\",\"PeriodicalId\":93973,\"journal\":{\"name\":\"DEN open\",\"volume\":\"5 1\",\"pages\":\"\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-07-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11248713/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"DEN open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/deo2.404\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"DEN open","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/deo2.404","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Unilateral drainage and chemotherapy prolong the patency of a plastic stent placed above the sphincter of Oddi in patients with malignant hilar biliary obstruction
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.
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