Covered duodenal self‐expandable metal stents prolong biliary stent patency in double stenting: The largest series of bilioduodenal obstruction. Issue 3 (22nd February 2018)

• Record Type: Journal Article
• Authors: Hori, Yasuki; Naitoh, Itaru; Hayashi, Kazuki; Kondo, Hiromu; Yoshida, Michihiro; Shimizu, Shuya; Hirano, Atsuyuki; Okumura, Fumihiro; Ando, Tomoaki; Jinno, Naruomi; Takada, Hiroki; Togawa, Shozo; Joh, Takashi
• Is Part Of: Journal of gastroenterology and hepatology. Volume 33:Issue 3(2018)
• Page Start: 696
• Page End: 703
• Publication Date: 2018-02-22
• Subjects: bilioduodenal obstruction -- double stenting -- self‐expandable metal stent; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.13977
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: Endoscopic biliary and duodenal stenting (DS; double stenting) is widely accepted as a palliation therapy for malignant bilioduodenal obstruction. The aim of the current study was to investigate the patency and adverse events of duodenal and biliary stents in patients with DS. Methods: Patients who underwent DS from April 2004 to March 2017 were analyzed retrospectively with regard to clinical outcomes and predictive factors of recurrent biliary and duodenal obstruction (recurrent biliary obstruction [RBO] and recurrent duodenal obstruction [RDO]). Results: A total of 109 consecutive patients was enrolled. Technical success of DS was achieved in 108 patients (99.1%). Symptoms due to biliary and duodenal obstruction were improved in 89 patients (81.7%). RBO occurred in 25 patients (22.9%) and RDO in 13 (11.9%). The median times to RBO and RDO from DS were 87 and 76 days, respectively. Placement of a duodenal uncovered self‐expandable metal stent (U‐SEMS) was significantly associated with RBO in the multivariable analysis ( P = 0.007). Time to RBO was significantly longer in the duodenal covered self‐expandable metal stent group than in the U‐SEMS group ( P = 0.003). No predictive factors of RDO were detected, and duodenal stent type was not associated with the time to RDO ( P = 0.724). Conclusions: Double stenting was safe and effective for malignant bilioduodenal obstruction. Duodenal U‐SEMS is a risk factor for RBO. The covered self‐expandable metal stent is the preferred type of duodenal SEMS in patients with DS (Clinical trial registration number: UMIN000027606).