| セッション情報 |
International Session6(消化器内視鏡学会・消化器病学会合同)
Strategy of biliary drainage for hilar biliary strictures
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| タイトル |
内IS6-5：Clinical differences between side-by-side and stent-in-stent deployment in bilateral endoscopic metal stenting for malignant hilar biliary obstruction
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| 演者 |
I. Naitoh（Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences） |
| 共同演者 |
K. Hayashi（Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences）, T. Nakazawa（Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences） |
| 抄録 |
Background and Aims: Side-by-side or stent-in-stent deployments are performed in bilateral drainage using a self-expanding metal stent (SEMS) for hilar malignant obstruction. However, the clinical differences between two deployments have not been evaluated. We aimed to clarify clinical features between two deployments.Methods: We compared side-by-side and stent-in-stent deployment in 52 consecutive patients with malignant hilar biliary obstruction who underwent endoscopic bilateral drainage using SEMS. Side-by-side deployment (SBS group) was performed in 28 patients and stent-in-stent deployment (SIS group) in 24 patients. Technical success, functional success, complications, stent occlusion and cumulative stent patency in SBS and SIS groups were compared retrospectively. Results: There were no significant inter-group differences in technical success (SBS vs SIS, 89% vs 100%, respectively), functional success (96% vs 100%), early complications (11% vs 4%), late complications (32% vs 8%) or stent occlusion (20% vs 42%). The incidence of complications was significantly higher for SBS than SIS (44% vs 13%; p=0.016). Cumulative stent patency was significantly better for SBS than SIS (log-rank, p=0.047). SBS was not associated with significantly longer cumulative stent patency in multivariate analysis (HR 0.39; 95% CI 0.13-1.16; p=0.090).Conclusions: The incidence of complications is higher for side-by-side than stent-in stent deployment. In terms of cumulative stent patency, side-by-side deployment tends to be more effective than stent-in-stent deployment. |
| 索引用語 |
hilar stenting, bilateral SEMS |
