The role of stent placement above the papilla (inside-stent) as a bridging therapy for perihilar biliary malignancy: an initial experience.
Inside-stent
Perihilar biliary malignancy
Stent placement above the papilla
Journal
Surgery today
ISSN: 1436-2813
Titre abrégé: Surg Today
Pays: Japan
ID NLM: 9204360
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
22
08
2020
accepted:
21
02
2021
pubmed:
10
4
2021
medline:
30
12
2021
entrez:
9
4
2021
Statut:
ppublish
Résumé
Although endoscopic naso-biliary drainage (ENBD) is a popular preoperative biliary drainage (PBD) method for patients with perihilar biliary malignancy (PHBM), patient discomfort caused by the nasal tube remains a problem. This study aimed to analyze the safety and efficacy of PBD with the placement of a plastic stent above the papilla [inside-stent (IS)] as a bridging therapy. The outcomes of 78 patients with potentially resectable PHBM, of whom 29 underwent IS placement and 49 underwent ENBD were evaluated. The stent-associated complication rates were not different between the two groups (7% in the IS group and 10% in the ENBD group, P = 0.621). Catheter dislocation occurred less frequently (0% vs. 22%, P = 0.016), and the median time to recurrent biliary obstruction was longer (not reached vs. 32 days, P = 0.039) in the IS group than in the ENBD group. Among the patients who underwent resection, their postoperative severe complication rates were not substantially different (26% vs. 25%, P = 0.923). IS placement is a possible alternative to ENBD as a bridge to a definitive operation for patients with resectable PHBM and a prospective trial to prove its feasibility and safety is therefore warranted.
Identifiants
pubmed: 33835263
doi: 10.1007/s00595-021-02268-8
pii: 10.1007/s00595-021-02268-8
doi:
Substances chimiques
Plastics
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1795-1804Informations de copyright
© 2021. Springer Nature Singapore Pte Ltd.
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