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Retrospective comparative study of new slim-delivery and conventional large-cell stents for stent-in-stent methods for hilar malignant biliary obstruction.
Ishigaki, Kazunaga; Fukuda, Rintaro; Nakai, Yousuke; Endo, Go; Kurihara, Kohei; Ishida, Kota; Tange, Shuichi; Takaoka, Shinya; Tokito, Yurie; Suzuki, Yukari; Oyama, Hiroki; Kanai, Sachiko; Suzuki, Tatsunori; Ito, Yukiko; Sato, Tatsuya; Hakuta, Ryunosuke; Saito, Kei; Saito, Tomotaka; Hamada, Tsuyoshi; Takahara, Naminatsu; Mizuno, Suguru; Kogure, Hirofumi; Fujishiro, Mitsuhiro.
Affiliation
  • Ishigaki K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Fukuda R; Department of Chemotherapy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Nakai Y; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Endo G; Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan.
  • Kurihara K; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Ishida K; Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Tange S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Takaoka S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Tokito Y; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Suzuki Y; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Oyama H; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Kanai S; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Suzuki T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Ito Y; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Sato T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Hakuta R; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Saito K; Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan.
  • Saito T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Hamada T; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Takahara N; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Mizuno S; Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
  • Kogure H; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Fujishiro M; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Dig Endosc ; 36(3): 360-369, 2024 Mar.
Article in En | MEDLINE | ID: mdl-37253160
ABSTRACT

OBJECTIVES:

Endoscopic management of unresectable hilar malignant biliary obstruction (HMBO) is technically challenging, and effectiveness of stent-in-stent using large-cell, metal stents was reported. A new, large-cell stent with a 6F tapered delivery system was recently developed. The aim of this study was to compare clinical outcomes of slim-delivery and conventional large-cell stents.

METHODS:

This was a multicenter retrospective comparative study of stent-in-stent methods using slim-delivery stents (Niti-S Large Cell SR Slim Delivery [LC slim-delivery]) and conventional stents (Niti-S large-cell D-type; LCD) for unresectable HMBO.

RESULTS:

Eighty-three patients with HMBO were included; 31 LC slim-delivery and 52 LCD. Overall technical and clinical success rates were 100% and 90% in LC slim-delivery group and 98% and 88% in LCD group. Use of the LC slim-delivery was associated with shorter stent placement time in the multiple regression analysis, with a stent placement time of 18 and 23 min in LC slim-delivery and LCD groups, respectively. The early adverse event (AE) rate of LC slim-delivery was 10%, with no cholangitis or cholecystitis as compared to 23% in the LCD group. Recurrent biliary obstruction (RBO) rates and time to RBO were comparable between the two groups 35% and 44%, and 8.5 and 8.0 months in LC slim-delivery and LCD groups, respectively. The major cause of RBO was tumor ingrowth (82%) in the LC slim-delivery group and sludge (43%) and ingrowth (48%) in LCD group.

CONCLUSION:

Stent-in-stent methods using LC slim-delivery shortened stent placement time with low early AE rates and comparable time to RBO in patients with HMBO.
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Full text: 1 Database: MEDLINE Main subject: Bile Duct Neoplasms / Cholangitis / Cholestasis Type of study: Clinical_trials / Risk_factors_studies Limits: Humans Language: En Year: 2024 Type: Article
Fulltext
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Full text: 1 Database: MEDLINE Main subject: Bile Duct Neoplasms / Cholangitis / Cholestasis Type of study: Clinical_trials / Risk_factors_studies Limits: Humans Language: En Year: 2024 Type: Article