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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(04): E340-E348
DOI: 10.1055/a-2039-4316
Original article

Comparison of 6-mm and 10-mm-diameter, fully-covered, self-expandable metallic stents for distal malignant biliary obstruction

Shota Harai
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
2   University of Yamanashi, Faculty of Medicine Graduate School of Medicine, First Department of Internal Medicine, Yamanashi, Japan
,
Susumu Hijioka 
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Yoshikuni Nagashio
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Akihiro Ohba
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Yuta Maruki
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Daiki Yamashige
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Yuya Hisada
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Motohiro Yoshinari
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Hidetoshi Kitamura
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Kosuke Maehara
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Yumi Murashima
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Yuki Kawasaki
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Takehiko Koga
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Kotaro Takeshita
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Hideki Ueno
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Shunsuke Kondo
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Chigusa Morizane
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Mitsuharu Fukasawa
2   University of Yamanashi, Faculty of Medicine Graduate School of Medicine, First Department of Internal Medicine, Yamanashi, Japan
,
Miyuki Sone
3   National Cancer Center Japan, Department of Diagnostic Radiology, Tokyo, Japan
,
Yutaka Saito
4   National Cancer Center Japan, Department of Endoscopy, Tokyo, Japan
,
Nobuyuki Enomoto
2   University of Yamanashi, Faculty of Medicine Graduate School of Medicine, First Department of Internal Medicine, Yamanashi, Japan
,
Takuji Okusaka
1   National Cancer Center Japan, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
› InstitutsangabenGefördert durch: Japanese Foundation for Research and Promotion of Endoscopy http://dx.doi.org/10.13039/100018254
Gefördert durch: The National Cancer Center Research and Development Fund 2022-A-16
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Abstract

Background and study aims For distal malignant biliary obstruction, self-expandable metallic stents (SEMSs) have a larger inner diameter compared to plastic stents, which prolongs time to recurrent biliary obstruction (TRBO), although stent-related complications are still a problem. This study aimed to compare the outcomes between using 10– and 6-mm-diameter fully-covered SEMS (FCSEMS) for distal malignant biliary obstruction.

Patients and methods This single-center, retrospective study included patients with 10-mm or 6-mm-diameter FCSEMS to treat distal malignant biliary obstruction. Clinical success, stent-related adverse events (AEs), cumulative incidence of RBO, factors involved in stent-related AEs, and factors involved in RBO were evaluated.

Results There were 243 eligible cases between October 2017 and December 2021. The cumulative incidence of RBO did not differ significantly between the 10-mm and 6-mm groups. Stent-related AEs occurred in 31.6 % and 11.4 % of patients between the 10-mm and 6-mm groups, respectively (P < 0.01). Pancreatitis occurred in 10.5 % and 3.6 % (P = 0.04) and cholecystitis occurred in 11.8 % and 3.0 % of patients (P = 0.03) in the 10-mm and 6-mm groups, respectively. In multivariate analysis, the 6-mm stent was extracted as a factor linked to a reduced risk of AEs, but not as a risk factor of RBO.

Conclusions The 6-mm-diameter FCSEMS for distal malignant biliary obstruction is a well-balanced stent with a cumulative incidence of RBO compatible to that of the 10-mm-diameter FCSEMS and fewer stent-related AEs.



Publikationsverlauf

Eingereicht: 17. Juli 2022

Angenommen nach Revision: 31. Januar 2023

Accepted Manuscript online:
21. Februar 2023

Artikel online veröffentlicht:
17. April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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