TY - JOUR
T1 - Retrospective Comparative Study of Side-by-Side and Stent-in-Stent Metal Stent Placement for Hilar Malignant Biliary Obstruction
AU - Ishigaki, Kazunaga
AU - Hamada, Tsuyoshi
AU - Nakai, Yousuke
AU - Isayama, Hiroyuki
AU - Sato, Tatsuya
AU - Hakuta, Ryunosuke
AU - Saito, Kei
AU - Saito, Tomotaka
AU - Takahara, Naminatsu
AU - Mizuno, Suguru
AU - Kogure, Hirofumi
AU - Ito, Yukiko
AU - Yagioka, Hiroshi
AU - Matsubara, Saburo
AU - Akiyama, Dai
AU - Mohri, Dai
AU - Tada, Minoru
AU - Koike, Kazuhiko
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/12
Y1 - 2020/12
N2 - Background: In patients with unresectable hilar malignant biliary obstruction (MBO), bilateral metal stent placement is recommended. However, treatment selection between partially stent-in-stent (SIS) and side-by-side (SBS) methods is still controversial. Study: Clinical outcomes of bilateral metal stent placement by SBS and SIS methods for hilar MBO were retrospectively studied in four Japanese centers. While large-cell-type uncovered metal stents were placed above the papilla in SIS, braided-type uncovered metal stents were placed across the papilla in SBS. Results: A total of 64 patients with hilar MBO (40 SIS and 24 SBS) were included in the analysis. Technical success rate was 100% in SIS and 96% in SBS. Functional success rate was 93% in SIS and 96% in SBS. Early adverse event rates were higher in SBS (46%) than in SIS (23%), though not statistically significant (P = 0.09). Post-procedure pancreatitis was exclusively observed in SBS group (29%). Recurrent biliary obstruction rates were 48% and 43%, and the median time to recurrent biliary obstruction was 169 and 205 days in SIS and SBS, respectively. Conclusions: Other than a trend to higher adverse event rates including post-procedure pancreatitis in SBS, clinical outcomes of SIS and SBS methods were comparable in patients with unresectable hilar MBO.
AB - Background: In patients with unresectable hilar malignant biliary obstruction (MBO), bilateral metal stent placement is recommended. However, treatment selection between partially stent-in-stent (SIS) and side-by-side (SBS) methods is still controversial. Study: Clinical outcomes of bilateral metal stent placement by SBS and SIS methods for hilar MBO were retrospectively studied in four Japanese centers. While large-cell-type uncovered metal stents were placed above the papilla in SIS, braided-type uncovered metal stents were placed across the papilla in SBS. Results: A total of 64 patients with hilar MBO (40 SIS and 24 SBS) were included in the analysis. Technical success rate was 100% in SIS and 96% in SBS. Functional success rate was 93% in SIS and 96% in SBS. Early adverse event rates were higher in SBS (46%) than in SIS (23%), though not statistically significant (P = 0.09). Post-procedure pancreatitis was exclusively observed in SBS group (29%). Recurrent biliary obstruction rates were 48% and 43%, and the median time to recurrent biliary obstruction was 169 and 205 days in SIS and SBS, respectively. Conclusions: Other than a trend to higher adverse event rates including post-procedure pancreatitis in SBS, clinical outcomes of SIS and SBS methods were comparable in patients with unresectable hilar MBO.
KW - Hilar malignant biliary obstruction
KW - Side-by-side deployment
KW - Stent-in-stent deployment
UR - http://www.scopus.com/inward/record.url?scp=85080145927&partnerID=8YFLogxK
U2 - 10.1007/s10620-020-06155-z
DO - 10.1007/s10620-020-06155-z
M3 - Article
C2 - 32107675
AN - SCOPUS:85080145927
SN - 0163-2116
VL - 65
SP - 3710
EP - 3718
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 12
ER -