Outcomes of 6‐mm diameter fully covered self‐expandable metal stents for preoperative biliary drainage in pancreatic cancer
Abstract Background 10‐mm self‐expandable metal stents (SEMSs) are commonly used for preoperative biliary drainage in pancreatic cancer. However, smaller diameter SEMSs have attracted attention with the attempt to reduce stent‐related adverse events (AEs). Methods We retrospectively analyzed consecu...
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Wiley
2024-04-01
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| Online Access: | https://doi.org/10.1002/deo2.360 |
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| author | Hiroki Nakagawa Tsuyoshi Takeda Takeshi Okamoto Takafumi Mie Akiyoshi Kasuga Takashi Sasaki Masato Ozaka Takahisa Matsuda Yoshinori Igarashi Naoki Sasahira |
| author_facet | Hiroki Nakagawa Tsuyoshi Takeda Takeshi Okamoto Takafumi Mie Akiyoshi Kasuga Takashi Sasaki Masato Ozaka Takahisa Matsuda Yoshinori Igarashi Naoki Sasahira |
| author_sort | Hiroki Nakagawa |
| collection | DOAJ |
| description | Abstract Background 10‐mm self‐expandable metal stents (SEMSs) are commonly used for preoperative biliary drainage in pancreatic cancer. However, smaller diameter SEMSs have attracted attention with the attempt to reduce stent‐related adverse events (AEs). Methods We retrospectively analyzed consecutive borderline resectable pancreatic cancer patients who underwent neoadjuvant therapy and fully covered SEMS (FCSEMS) placement from April 2015 to May 2023. The primary outcome was stent‐related non‐event rate (NER), which was defined as the rate of completion of surgery without developing any preoperative events (recurrent biliary obstruction [RBO] or stent‐related AEs). Secondary outcomes included stent‐related AEs, causes of RBO, and cumulative incidence of RBO. Risk factors for pancreatitis, RBO, and stent migration were also examined. Results A total of 76 patients were included (6‐mm group: 23; 10‐mm group: 53). Stent‐related NER (57% vs. 64%, p = 0.610), stent‐related AEs (4% vs. 15%, p = 0.263), overall RBO rates (39% vs. 23%, p = 0.168), cumulative incidence of RBO (hazard ratio, 2.24; 95% confidence interval, 0.95–5.25; p = 0.065) were not significantly different between the two groups. Tumor involvement of the pancreatic duct was identified as a risk‐reducing factor for pancreatitis, while an FCSEMS diameter of 6 mm was not identified as a risk factor for RBO and stent migration. Conclusions Stent‐related NER was not significantly affected by FCSEMS diameter. Further studies are needed to confirm the usefulness of 6‐mm diameter FCSEMS for preoperative biliary drainage in patients with borderline resectable pancreatic cancer. |
| format | Article |
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| institution | Kabale University |
| issn | 2692-4609 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | DEN Open |
| spelling | doaj-art-d3480b3ae9744820b93ccd2ad19ff6032025-08-20T03:41:00ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.360Outcomes of 6‐mm diameter fully covered self‐expandable metal stents for preoperative biliary drainage in pancreatic cancerHiroki Nakagawa0Tsuyoshi Takeda1Takeshi Okamoto2Takafumi Mie3Akiyoshi Kasuga4Takashi Sasaki5Masato Ozaka6Takahisa Matsuda7Yoshinori Igarashi8Naoki Sasahira9Department of Hepato‐Biliary‐Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Hepato‐Biliary‐Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Hepato‐Biliary‐Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Hepato‐Biliary‐Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Hepato‐Biliary‐Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Hepato‐Biliary‐Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Hepato‐Biliary‐Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of Internal Medicine Division of Gastroenterology and Hepatology, Omori Medical Center Toho University Tokyo JapanDepartment of Internal Medicine Division of Gastroenterology and Hepatology, Omori Medical Center Toho University Tokyo JapanDepartment of Hepato‐Biliary‐Pancreatic Medicine Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanAbstract Background 10‐mm self‐expandable metal stents (SEMSs) are commonly used for preoperative biliary drainage in pancreatic cancer. However, smaller diameter SEMSs have attracted attention with the attempt to reduce stent‐related adverse events (AEs). Methods We retrospectively analyzed consecutive borderline resectable pancreatic cancer patients who underwent neoadjuvant therapy and fully covered SEMS (FCSEMS) placement from April 2015 to May 2023. The primary outcome was stent‐related non‐event rate (NER), which was defined as the rate of completion of surgery without developing any preoperative events (recurrent biliary obstruction [RBO] or stent‐related AEs). Secondary outcomes included stent‐related AEs, causes of RBO, and cumulative incidence of RBO. Risk factors for pancreatitis, RBO, and stent migration were also examined. Results A total of 76 patients were included (6‐mm group: 23; 10‐mm group: 53). Stent‐related NER (57% vs. 64%, p = 0.610), stent‐related AEs (4% vs. 15%, p = 0.263), overall RBO rates (39% vs. 23%, p = 0.168), cumulative incidence of RBO (hazard ratio, 2.24; 95% confidence interval, 0.95–5.25; p = 0.065) were not significantly different between the two groups. Tumor involvement of the pancreatic duct was identified as a risk‐reducing factor for pancreatitis, while an FCSEMS diameter of 6 mm was not identified as a risk factor for RBO and stent migration. Conclusions Stent‐related NER was not significantly affected by FCSEMS diameter. Further studies are needed to confirm the usefulness of 6‐mm diameter FCSEMS for preoperative biliary drainage in patients with borderline resectable pancreatic cancer.https://doi.org/10.1002/deo2.360distal malignant biliary obstructionneoadjuvant therapypancreatic cancerpancreatitispreoperative biliary drainage |
| spellingShingle | Hiroki Nakagawa Tsuyoshi Takeda Takeshi Okamoto Takafumi Mie Akiyoshi Kasuga Takashi Sasaki Masato Ozaka Takahisa Matsuda Yoshinori Igarashi Naoki Sasahira Outcomes of 6‐mm diameter fully covered self‐expandable metal stents for preoperative biliary drainage in pancreatic cancer DEN Open distal malignant biliary obstruction neoadjuvant therapy pancreatic cancer pancreatitis preoperative biliary drainage |
| title | Outcomes of 6‐mm diameter fully covered self‐expandable metal stents for preoperative biliary drainage in pancreatic cancer |
| title_full | Outcomes of 6‐mm diameter fully covered self‐expandable metal stents for preoperative biliary drainage in pancreatic cancer |
| title_fullStr | Outcomes of 6‐mm diameter fully covered self‐expandable metal stents for preoperative biliary drainage in pancreatic cancer |
| title_full_unstemmed | Outcomes of 6‐mm diameter fully covered self‐expandable metal stents for preoperative biliary drainage in pancreatic cancer |
| title_short | Outcomes of 6‐mm diameter fully covered self‐expandable metal stents for preoperative biliary drainage in pancreatic cancer |
| title_sort | outcomes of 6 mm diameter fully covered self expandable metal stents for preoperative biliary drainage in pancreatic cancer |
| topic | distal malignant biliary obstruction neoadjuvant therapy pancreatic cancer pancreatitis preoperative biliary drainage |
| url | https://doi.org/10.1002/deo2.360 |
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