Feasibility of one‐step endoscopic metal stenting for distal malignant biliary obstruction. (1st August 2013)

• Record Type: Journal Article
• Authors: Shimizu, Shuya; Naitoh, Itaru; Nakazawa, Takahiro; Hayashi, Kazuki; Miyabe, Katsuyuki; Kondo, Hiromu; Yoshida, Michihiro; Yamashita, Hiroaki; Ohara, Hirotaka; Joh, Takashi
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 21:Number 3(2014)
• Page Start: 219
• Page End: 225
• Publication Date: 2013-08-01
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.22
• Languages: English
• ISSNs: 1868-6974

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jhbp22-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="jhbp22-sec-0002" sec-type="section"> <title>Methods</title> <p>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).</p> </sec> <sec id="jhbp22-sec-0003" sec-type="section"> <title>Results</title> <p>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]; <italic>P</italic> = 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]; <italic>P</italic> = 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; <italic>P</italic> = 0.025). Similar results were observed in the period of hospitalization for patients without chemotherapy (22.2 vs. 37.3 days; <italic>P</italic> = 0.004).</p> </sec> <sec id="jhbp22-sec-0004" sec-type="section"> <title>Conclusions</title> <p>One‐step SEMS placement is the alternative option of drainage method for distal malignant biliary obstruction.</p> </sec> </abstract>