Clinical Endoscopy

  • 제55권3호
  • /
  • Pages.434-442
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  • 2022
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study

  • Koh Kitagawa (Department of Gastroenterology, Nara Medical University) ;
  • Akira Mitoro (Department of Gastroenterology, Nara Medical University) ;
  • Takahiro Ozutsumi (Department of Gastroenterology, Nara Medical University) ;
  • Masanori Furukawa (Department of Gastroenterology, Nara Medical University) ;
  • Yukihisa Fujinaga (Department of Gastroenterology, Nara Medical University) ;
  • Kenichiro Seki (Department of Gastroenterology, Nara Medical University) ;
  • Norihisa Nishimura (Department of Gastroenterology, Nara Medical University) ;
  • Yasuhiko Sawada (Department of Gastroenterology, Nara Medical University) ;
  • Kosuke Kaji (Department of Gastroenterology, Nara Medical University) ;
  • Hideto Kawaratani (Department of Gastroenterology, Nara Medical University) ;
  • Hiroaki Takaya (Department of Gastroenterology, Nara Medical University) ;
  • Kei Moriya (Department of Gastroenterology, Nara Medical University) ;
  • Tadashi Namisaki (Department of Gastroenterology, Nara Medical University) ;
  • Takemi Akahane (Department of Gastroenterology, Nara Medical University) ;
  • Hitoshi Yoshiji (Department of Gastroenterology, Nara Medical University)
  • 투고 : 2021.05.17
  • 심사 : 2021.07.11
  • 발행 : 2022.05.30
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초록

Background/Aims: Covered self-expandable metallic stents (CMSs) are widely used for malignant distal biliary obstructions (MDBOs) caused by pancreatic carcinoma. This study compared the efficacy and safety of the laser-cut-type and braided-type CMSs. Methods: To palliate MDBOs caused by pancreatic carcinoma, the laser-cut-type CMSs was used from April 2014 to March 2017, and the braided-type CMSs was used from April 2017 to March 2019. The tested self-expandable metallic stents were equipped with different anti-migration systems. Results: In total, 47 patients received CMSs for MDBOs (24 laser-cut type, 23 braided-type). The time to recurrent biliary obstruction (TRBO) was significantly longer in the braided-type CMSs (p=0.0008), and the median time to stent dysfunction or patient death was 141 and 265 days in the laser-cut-type CMSs and braided-type CMSs, respectively (p=0.0023). Stent migration was the major cause of stent dysfunction in both groups, which occurred in 37.5% of the laser-cut-type CMSs and 13.0% of the braided-type CMSs. There were no differences in the survival duration between the groups. Conclusions: The TRBO was significantly longer for the braided-type CMSs with an anti-migration system than for the laser-cut-type. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.

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참고문헌

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