Potential of 6-mm-diameter fully covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a propensity score-matched study
Background/Aims To date, only thinner-diameter metal stents have been evaluated for unresectable malignant distal biliary obstruction (UR-MDBO). This study investigated the outcomes and optimal cohorts for a 6-mm-diameter fully covered self-expandable metal stent (FCSEMS) compared with those for a 1...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2025-01-01
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| Series: | Clinical Endoscopy |
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| Online Access: | http://www.e-ce.org/upload/pdf/ce-2024-044.pdf |
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| author | Daiki Yamashige Susumu Hijioka Yoshikuni Nagashio Yuta Maruki Soma Fukuda Shin Yagi Kohei Okamoto Hidenobu Hara Yuya Hagiwara Daiki Agarie Tetsuro Takasaki Akihiro Ohba Shunsuke Kondo Chigusa Morizane Hideki Ueno Miyuki Sone Yutaka Saito Takuji Okusaka |
| author_facet | Daiki Yamashige Susumu Hijioka Yoshikuni Nagashio Yuta Maruki Soma Fukuda Shin Yagi Kohei Okamoto Hidenobu Hara Yuya Hagiwara Daiki Agarie Tetsuro Takasaki Akihiro Ohba Shunsuke Kondo Chigusa Morizane Hideki Ueno Miyuki Sone Yutaka Saito Takuji Okusaka |
| author_sort | Daiki Yamashige |
| collection | DOAJ |
| description | Background/Aims To date, only thinner-diameter metal stents have been evaluated for unresectable malignant distal biliary obstruction (UR-MDBO). This study investigated the outcomes and optimal cohorts for a 6-mm-diameter fully covered self-expandable metal stent (FCSEMS) compared with those for a 10-mm-diameter FCSEMS. Methods This single-center retrospective cohort study included patients who underwent initial transpapillary metal stenting for UR-MDBO. Propensity score matching (1:1) analysis was performed. Results Of 133/68 patients who underwent 6-mm/10-mm-diameter FCSEMS deployment, 59 in each group were selected. The median time to recurrent biliary obstruction was not significantly different between the groups (p=0.46). In contrast, use of the 6-mm-diameter FCSEMS resulted in a significantly reduced incidence of stent-related adverse events (AEs) (p=0.016), especially cholecystitis (p=0.032), and patients aged <70 years were particularly affected by this significant reduction. Among the patients in the end-stage cohort who were unable to continue chemotherapy after FCSEMS deployment, the free rate of stent-related events, including recurrent biliary obstruction and stent-related AEs, was significantly higher in the 6-mm group (p=0.027). Conclusions For UR-MDBO, a 6-mm-diameter FCSEMS can be an optimal and safe option in the younger cohort with a relatively high risk of AEs and in the end-stage cohort requiring safer drainage without interference from stent-related events during times of poor prognosis. |
| format | Article |
| id | doaj-art-a726589c986f46bc865d0491aad7860c |
| institution | Kabale University |
| issn | 2234-2400 2234-2443 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj-art-a726589c986f46bc865d0491aad7860c2025-02-03T08:08:03ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432025-01-0158112113310.5946/ce.2024.0447898Potential of 6-mm-diameter fully covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a propensity score-matched studyDaiki Yamashige0Susumu Hijioka1Yoshikuni Nagashio2Yuta Maruki3Soma Fukuda4Shin Yagi5Kohei Okamoto6Hidenobu Hara7Yuya Hagiwara8Daiki Agarie9Tetsuro Takasaki10Akihiro Ohba11Shunsuke Kondo12Chigusa Morizane13Hideki Ueno14Miyuki Sone15Yutaka Saito16Takuji Okusaka17 Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, JapanBackground/Aims To date, only thinner-diameter metal stents have been evaluated for unresectable malignant distal biliary obstruction (UR-MDBO). This study investigated the outcomes and optimal cohorts for a 6-mm-diameter fully covered self-expandable metal stent (FCSEMS) compared with those for a 10-mm-diameter FCSEMS. Methods This single-center retrospective cohort study included patients who underwent initial transpapillary metal stenting for UR-MDBO. Propensity score matching (1:1) analysis was performed. Results Of 133/68 patients who underwent 6-mm/10-mm-diameter FCSEMS deployment, 59 in each group were selected. The median time to recurrent biliary obstruction was not significantly different between the groups (p=0.46). In contrast, use of the 6-mm-diameter FCSEMS resulted in a significantly reduced incidence of stent-related adverse events (AEs) (p=0.016), especially cholecystitis (p=0.032), and patients aged <70 years were particularly affected by this significant reduction. Among the patients in the end-stage cohort who were unable to continue chemotherapy after FCSEMS deployment, the free rate of stent-related events, including recurrent biliary obstruction and stent-related AEs, was significantly higher in the 6-mm group (p=0.027). Conclusions For UR-MDBO, a 6-mm-diameter FCSEMS can be an optimal and safe option in the younger cohort with a relatively high risk of AEs and in the end-stage cohort requiring safer drainage without interference from stent-related events during times of poor prognosis.http://www.e-ce.org/upload/pdf/ce-2024-044.pdfbile duct obstructioncholangitisdrainagepancreatitis |
| spellingShingle | Daiki Yamashige Susumu Hijioka Yoshikuni Nagashio Yuta Maruki Soma Fukuda Shin Yagi Kohei Okamoto Hidenobu Hara Yuya Hagiwara Daiki Agarie Tetsuro Takasaki Akihiro Ohba Shunsuke Kondo Chigusa Morizane Hideki Ueno Miyuki Sone Yutaka Saito Takuji Okusaka Potential of 6-mm-diameter fully covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a propensity score-matched study Clinical Endoscopy bile duct obstruction cholangitis drainage pancreatitis |
| title | Potential of 6-mm-diameter fully covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a propensity score-matched study |
| title_full | Potential of 6-mm-diameter fully covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a propensity score-matched study |
| title_fullStr | Potential of 6-mm-diameter fully covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a propensity score-matched study |
| title_full_unstemmed | Potential of 6-mm-diameter fully covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a propensity score-matched study |
| title_short | Potential of 6-mm-diameter fully covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a propensity score-matched study |
| title_sort | potential of 6 mm diameter fully covered self expandable metal stents for unresectable malignant distal biliary obstruction a propensity score matched study |
| topic | bile duct obstruction cholangitis drainage pancreatitis |
| url | http://www.e-ce.org/upload/pdf/ce-2024-044.pdf |
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