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Risk factors for recurrent biliary obstruction following endoscopic biliary stenting in patients with unresectable ampullary cancer: A multicenter retrospective study.
Sugiura, Ryo; Kuwatani, Masaki; Kin, Toshifumi; Matsumoto, Ryusuke; Ikeda, Yuki; Sano, Itsuki; Hirata, Koji; Yoshida, Makoto; Masaki, Yoshiharu; Ono, Michihiro; Hirata, Hajime; Yamato, Hiroaki; Onodera, Manabu; Nakamura, Hideaki; Taya, Yoko; Ehira, Nobuyuki; Nakajima, Masahito; Kawabata, Hidemasa; Ihara, Hideyuki; Kudo, Taiki; Kato, Shin; Katanuma, Akio.
Afiliación
  • Sugiura R; Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
  • Kuwatani M; Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
  • Kin T; Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Hokkaido, Japan.
  • Matsumoto R; Department of Gastroenterology, Obihiro Kosei Hospital, Obihiro, Hokkaido, Japan.
  • Ikeda Y; Department of Gastroenterology, Oji General Hospital, Tomakomai, Hokkaido, Japan.
  • Sano I; Department of Internal Medicine, Kushiro Rosai Hospital, Kushiro, Hokkaido, Japan.
  • Hirata K; Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan.
  • Yoshida M; Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
  • Masaki Y; Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
  • Ono M; Department of Gastroenterology, Steel Memorial Muroran Hospital, Muroran, Hokkaido, Japan.
  • Hirata H; Department of Gastroenterology, Tomakomai City Hospital, Tomakomai, Hokkaido, Japan.
  • Yamato H; Department of Gastroenterology, Iwamizawa Municipal General Hospital, Iwamizawa, Hokkaido, Japan.
  • Onodera M; Department of Gastroenterology, NTT East Sapporo Hospital, Sapporo, Hokkaido, Japan.
  • Nakamura H; Department of Gastroenterology, Hokkaido Gastroenterology Hospital, Sapporo, Hokkaido, Japan.
  • Taya Y; Department of Gastroenterology, Hokkaido Medical Center, Sapporo, Hokkaido, Japan.
  • Ehira N; Department of Gastroenterology, Kitami Red Cross Hospital, Kitami, Hokkaido, Japan.
  • Nakajima M; Department of Gastroenterology, Aiiku Hospital, Sapporo, Hokkaido, Japan.
  • Kawabata H; Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
  • Ihara H; Department of Gastroenterology, Tonan Hospital, Sapporo, Hokkaido, Japan.
  • Kudo T; Department of Gastroenterology, IMS Sapporo Digestive Disease Center General Hospital, Sapporo, Hokkaido, Japan.
  • Kato S; Department of Gastroenterology, Sapporo City General Hospital, Sapporo, Hokkaido, Japan.
  • Katanuma A; Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Hokkaido, Japan.
J Dig Dis ; 25(5): 310-317, 2024 May.
Article en En | MEDLINE | ID: mdl-38973135
ABSTRACT

OBJECTIVES:

Unresectable ampullary cancer (AC) is a rare disease entity. The risk factors for recurrent biliary obstruction (RBO) following endoscopic biliary stenting (EBS) for unresectable AC remain unknown. In this study we aimed to evaluate the cumulative RBO rate and to identify risk factors for RBO following palliative EBS in patients with unresectable AC.

METHODS:

This multicenter retrospective observational study enrolled consecutive patients with unresectable AC who had undergone palliative EBS between April 2011 and December 2021. The cumulative rate of and risk factors for RBO following palliative EBS were evaluated via multivariate analysis.

RESULTS:

The study analysis comprised 107 patients with a median age of 84 years (interquartile range 79-88 years). Plastic stents (PSs) and self-expandable metal stents (SEMSs) were placed in 53 and 54 patients, respectively. Functional success was accomplished in 104 (97.2%) patients. Of these, RBO occurred in 62 (59.6%) patients, with obstruction and complete/partial migration occurring in 47 and 15 patients, respectively. The median time to RBO was 190 days. Multivariate analysis showed that PS was associated with a higher rate of RBO compared to SEMS (hazard ratio [HR] 2.48; P < 0.01) and that the presence of common bile duct stones/sludge immediately after EBS was an independent risk factor for RBO (HR 1.99; P = 0.04).

CONCLUSIONS:

The use of SEMS compared to PS during EBS reduced the time to RBO in patients with unresectable AC. Common bile duct stones/sludge immediately after EBS was a risk factor for RBO.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Paliativos / Recurrencia / Ampolla Hepatopancreática / Stents / Colestasis / Neoplasias del Conducto Colédoco Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: J Dig Dis Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Paliativos / Recurrencia / Ampolla Hepatopancreática / Stents / Colestasis / Neoplasias del Conducto Colédoco Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: J Dig Dis Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Australia