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Feasibility of one-step endoscopic metal stenting for distal malignant biliary obstruction.

Abstract：

BACKGROUND:We aimed to clarify the clinical usefulness of one-step self-expandable metal stent (SEMS) placement for distal malignant biliary obstruction by comparing with two-step SEMS placement. METHODS:We retrospectively compared early complications, bilirubin level decreasing rate, and period of hospitalization between 40 patients with one-step SEMS and 52 patients with two-step SEMS. We also evaluated the complications in patients with two-step SEMS by classifying them into first drainage (ERBD or ENBD) and second drainage (SEMS). RESULTS:The total incidence of early complications was significantly higher in patients with one-step SEMS than the second drainage of two-step SEMS (42.5% [17/40] vs. 13.5% [7/52]; P = 0.004). However, there was no significant difference in the early complications between one-step SEMS and two-step SEMS (total of first and second drainage) (42.5% [17/40] vs. 36.5% [19/52]; P = 0.561). The period required to reach the bilirubin level (<3 mg/dL) after initial drainage was significantly shorter in one-step SEMS than in two-step SEMS (5.7 vs. 10.1 days; P = 0.025). Similar results were observed in the period of hospitalization for patients without chemotherapy (22.2 vs. 37.3 days; P = 0.004). CONCLUSIONS:One-step SEMS placement is the alternative option of drainage method for distal malignant biliary obstruction.

journal_name

J Hepatobiliary Pancreat Sci

journal_title

Journal of hepato-biliary-pancreatic sciences

authors

Shimizu S,Naitoh I,Nakazawa T,Hayashi K,Miyabe K,Kondo H,Yoshida M,Yamashita H,Ohara H,Joh T

doi

10.1002/jhbp.22

subject

Has Abstract

pub_date

2014-03-01 00:00:00

pages

219-25

issue

3

eissn

1868-6974

issn

1868-6982

journal_volume

21

pub_type

杂志文章

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