Purpose: Endoscopic bile duct decompression using bilateral self-expandable metallic stents (SEMSs) deployed via a stent-in-stent (SIS) method is considered a preferred procedure for malignant hilar biliary obstruction (MHBO). However, occlusion thereof occurs frequently. Here, we investigated stent patency duration and risk factors related to stent obstruction with bilateral SIS placement for MHBO at two large centers.
Materials And Methods: The present study reviewed data on patients with MHBO who underwent endoscopic biliary drainage using the SIS method. Clinical outcomes, including stent patency duration and patient overall survival, were analyzed. Factors associated with stent patency were evaluated using Cox proportional hazards models.
Results: Seventy patients with MHBO underwent endoscopic biliary drainage using the SIS method. Median age was 68 years old, and median follow-up duration was 140 days (interquartile range, 57-329). The proportion of high-grade MHBOs (Bismuth type IV) was 57.1%. Median stent patency duration with the SIS method was 108 days according to Kaplan-Meier curves. Median patient survival analyzed by the Kaplan-Meier method was 181 days. Multivariate analysis indicated that higher baseline bilirubin (> 6.1 mg/dL) as an independent risk factor related to stent patency (p<0.05).
Conclusion: In endoscopic biliary decompression using SEMS placed with the SIS method, obstructive jaundice was a risk factor for stent patency. The SIS method for high-grade MHBO showed short stent patency.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082981 | PMC |
| http://dx.doi.org/10.3349/ymj.2018.59.7.827 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Hydrogel-Impregnated Robust Interlocking Nano Connector (HiRINC) for Noninvasive Anti-Migration of Esophageal Stent.
Adv Mater
March 2025
Department of Chemistry, Hanyang University, Seoul, 04763, Republic of Korea.
Migration of implanted self-expandable metallic stent (SEMS) in the malignant or benign esophageal stricture is a common complication but not yet resolved. Herein, this research develops a hydrogel-impregnated robust interlocking nano connector (HiRINC) to ensure adhesion and reduce the mechanical mismatch between SEMSs and esophageal tissues. Featuring a network-like porous layer, HiRINC significantly enhances adhesion and energy dissipation during esophageal peristalsis by utilizing mechanical interlocking and increasing hydrogen bonding sites, thereby securing SEMS to tissues.
View Article and Find Full Text PDFPediatric living donor liver transplantation for small infants with biliary atresia using interposition portal vein grafts, multi-center cohort study.
Liver Transpl
March 2025
Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
Background: Despite multiple techniques, portal vein (PV) inflow reconstruction during living donor liver transplantation (LDLT) for patients with biliary atresia (BA) and small-diameter PV remains a challenge. The use of PV interposition grafts has emerged as a promising therapeutic strategy to mitigate complications and reinterventions.
Methods: We conducted a retrospective multi-center cohort study of patients under 3 years of age (n=85) undergoing LDLT for biliary atresia using PV interposition grafts.
Endovascular treatment and hybrid surgery for extracranial internal carotid artery aneurysms.
Ann Vasc Surg
March 2025
Department of Vascular Surgery, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China. Electronic address:
Background: Extracranial internal carotid artery aneurysms (EICAAs) are rare, and both endovascular treatment and hybrid surgery have been used to treat them. Herein, we evaluated the outcomes of endovascular treatment and hybrid surgery for EICAAs treated at our institution.
Methods: Twenty-eight patients diagnosed with EICAA and treated with endovascular treatment or hybrid surgery in our center from January 2013 to June 2023 were retrospectively reviewed.
Risk Factors for Cholecystitis After Self-expandable Metallic Stent Placement for Malignant Distal Biliary Obstruction: A Systematic Review and Meta-analysis.
J Clin Gastroenterol
March 2025
Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN.
Background And Goals: Endoscopic biliary stenting is a standard palliative procedure to improve the quality of life in patients with unresectable malignant distal biliary obstruction (MDBO). Self-expandable metallic stents (SEMS) are preferred for their longer patency than plastic stents. However, cholecystitis can complicate SEMS placement by obstructing the cystic duct.
View Article and Find Full Text PDFComparison of outcomes for Draf IIB vs Draf III in endoscopic frontal sinus surgery: a comprehensive systematic review and meta-analysis.
Rhinology
March 2025
Department of Otolaryngology, University Hospitals Northamptonshire, Cliftonville, Northampton, United Kingdom.
Background: Understanding the factors associated with increased rates of restenosis following Draf procedures is crucial for developing targeted strategies to mitigate complications such as mucocele formation, reduce the need for revision surgeries, and improve long-term patient outcomes.
Methodology: A systematic search was conducted using Embase, Medline, CINAHL, AMED, PubMed, and the Cochrane Database on January 17th, 2024. Research articles published in English language were included.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!