Jae Min Lee1,2, Sang Hyub Lee1, Kwang Hyun Chung1, Jin Myung Park3, Woo Hyun Paik4, Sang Myung Woo5, Woo Jin Lee5, Ji Kon Ryu1, Yong-Tae Kim1. 1. Departments of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul, Korea. 2. Department of Internal Medicine, Gyeongsang National University College of Medicine, Gyeongsang National University Hospital, Jinju, Korea. 3. Department of Internal Medicine, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon, Korea. 4. Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea. 5. Center for Liver Cancer, National Cancer Center, Goyang, Korea.
Abstract
BACKGROUND AND AIM: Although the large cell-sized biliary stent facilitates contralateral stent deployment through the mesh of the first metallic stent for stent-in-stent (SIS) technique, there are concerns about its vulnerability to tumor ingrowth. The aim of the present study was to compare the clinical outcomes of endoscopic bilateral SIS placement according to the cell size of a self-expandable metallic stent (SEMS). METHODS: A total of 58 patients were enrolled who underwent endoscopic bilateral SIS placement of SEMS for malignant hilar biliary obstruction as a result of cholangiocarcinoma or gallbladder cancer. Finally, 43 patients who underwent successful stent insertion were included in the analysis and divided into the small cell-sized stent (SCS; n = 21) and the large cell-sized stent (LCS; n = 22) groups. We retrospectively compared comprehensive clinical and laboratory data in both groups. RESULTS: There were no significant differences between the two groups in successful drainage (SCS vs LCS, 100% vs 100%, respectively), early complications (38.1% vs 18.2%), late complications (14.3% vs 22.7%), stent occlusion (42.9% vs 45.5%), tumor ingrowth (33.3% vs 45.5%) or overgrowth (9.5% vs 0%). Duration of stent patency and overall survival were not significantly different between the two groups (P = 0.086 and P = 0.320, respectively). CONCLUSIONS: Endoscopic bilateral SIS placement for malignant hilar biliary obstruction shows no differences in stent patency, survival, complications and clinical course according to the cell size of SEMS.
BACKGROUND AND AIM: Although the large cell-sized biliary stent facilitates contralateral stent deployment through the mesh of the first metallic stent for stent-in-stent (SIS) technique, there are concerns about its vulnerability to tumor ingrowth. The aim of the present study was to compare the clinical outcomes of endoscopic bilateral SIS placement according to the cell size of a self-expandable metallic stent (SEMS). METHODS: A total of 58 patients were enrolled who underwent endoscopic bilateral SIS placement of SEMS for malignant hilar biliary obstruction as a result of cholangiocarcinoma or gallbladder cancer. Finally, 43 patients who underwent successful stent insertion were included in the analysis and divided into the small cell-sized stent (SCS; n = 21) and the large cell-sized stent (LCS; n = 22) groups. We retrospectively compared comprehensive clinical and laboratory data in both groups. RESULTS: There were no significant differences between the two groups in successful drainage (SCS vs LCS, 100% vs 100%, respectively), early complications (38.1% vs 18.2%), late complications (14.3% vs 22.7%), stent occlusion (42.9% vs 45.5%), tumor ingrowth (33.3% vs 45.5%) or overgrowth (9.5% vs 0%). Duration of stent patency and overall survival were not significantly different between the two groups (P = 0.086 and P = 0.320, respectively). CONCLUSIONS: Endoscopic bilateral SIS placement for malignant hilar biliary obstruction shows no differences in stent patency, survival, complications and clinical course according to the cell size of SEMS.
Authors: Hoonsub So; Chi Hyuk Oh; Tae Jun Song; Sung Woo Ko; Jun Seong Hwang; Dongwook Oh; Do Hyun Park; Sang Soo Lee; Dong-Wan Seo; Seok Ho Dong; Sung Koo Lee; Myung-Hwan Kim Journal: PLoS One Date: 2021-03-29 Impact factor: 3.240
Authors: Min Jae Yang; Jin Hong Kim; Jae Chul Hwang; Byung Moo Yoo; Sang Hyub Lee; Ji Kon Ryu; Yong-Tae Kim; Sang Myung Woo; Woo Jin Lee; Seok Jeong; Don Haeng Lee Journal: Gut Liver Date: 2018-11-15 Impact factor: 4.519