Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study.

Adverse effects Biliary tract Self-expandable metallic stents

Journal

Clinical endoscopy
ISSN: 2234-2400
Titre abrégé: Clin Endosc
Pays: Korea (South)
ID NLM: 101576886

Informations de publication

Date de publication:
May 2022
Historique:
received: 17 05 2021
accepted: 11 07 2021
pubmed: 29 10 2021
medline: 29 10 2021
entrez: 28 10 2021
Statut: ppublish

Résumé

Covered self-expandable metallic stents (CMSs) are widely used for malignant distal biliary obstructions (MDBOs) caused by pancreatic carcinoma. This study compared the efficacy and safety of the laser-cut-type and braided-type CMSs. To palliate MDBOs caused by pancreatic carcinoma, the laser-cut-type CMSs was used from April 2014 to March 2017, and the braided-type CMSs was used from April 2017 to March 2019. The tested self-expandable metallic stents were equipped with different anti-migration systems. In total, 47 patients received CMSs for MDBOs (24 laser-cut type, 23 braided-type). The time to recurrent biliary obstruction (TRBO) was significantly longer in the braided-type CMSs (p=0.0008), and the median time to stent dysfunction or patient death was 141 and 265 days in the laser-cut-type CMSs and braided-type CMSs, respectively (p=0.0023). Stent migration was the major cause of stent dysfunction in both groups, which occurred in 37.5% of the laser-cut-type CMSs and 13.0% of the braidedtype CMSs. There were no differences in the survival duration between the groups. The TRBO was significantly longer for the braided-type CMSs with an anti-migration system than for the laser-cuttype. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.

Sections du résumé

BACKGROUND/AIMS OBJECTIVE
Covered self-expandable metallic stents (CMSs) are widely used for malignant distal biliary obstructions (MDBOs) caused by pancreatic carcinoma. This study compared the efficacy and safety of the laser-cut-type and braided-type CMSs.
METHODS METHODS
To palliate MDBOs caused by pancreatic carcinoma, the laser-cut-type CMSs was used from April 2014 to March 2017, and the braided-type CMSs was used from April 2017 to March 2019. The tested self-expandable metallic stents were equipped with different anti-migration systems.
RESULTS RESULTS
In total, 47 patients received CMSs for MDBOs (24 laser-cut type, 23 braided-type). The time to recurrent biliary obstruction (TRBO) was significantly longer in the braided-type CMSs (p=0.0008), and the median time to stent dysfunction or patient death was 141 and 265 days in the laser-cut-type CMSs and braided-type CMSs, respectively (p=0.0023). Stent migration was the major cause of stent dysfunction in both groups, which occurred in 37.5% of the laser-cut-type CMSs and 13.0% of the braidedtype CMSs. There were no differences in the survival duration between the groups.
CONCLUSION CONCLUSIONS
The TRBO was significantly longer for the braided-type CMSs with an anti-migration system than for the laser-cuttype. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.

Identifiants

pubmed: 34706489
pii: ce.2021.161
doi: 10.5946/ce.2021.161
pmc: PMC9178141
doi:

Types de publication

Journal Article

Langues

eng

Pagination

434-442

Commentaires et corrections

Type : CommentIn

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Auteurs

Koh Kitagawa (K)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Akira Mitoro (A)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Takahiro Ozutsumi (T)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Masanori Furukawa (M)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Yukihisa Fujinaga (Y)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Kenichiro Seki (K)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Norihisa Nishimura (N)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Yasuhiko Sawada (Y)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Kosuke Kaji (K)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Hideto Kawaratani (H)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Hiroaki Takaya (H)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Kei Moriya (K)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Tadashi Namisaki (T)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Takemi Akahane (T)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Hitoshi Yoshiji (H)

Department of Gastroenterology, Nara Medical University, Nara, Japan.

Classifications MeSH