| 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IS6-6：Endoscopic multiple deployment of metallic stents is feasible and effective for the patients with unresectable hilar biliary strictures.
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| 演者 |
H. Kato（Departments of Gastroenterology and Hepatology, Okayama University） |
| 共同演者 |
H. Okada（Departments of Gastroenterology and Hepatology, Okayama University）, K. Yamamoto（Departments of Gastroenterology and Hepatology, Okayama University） |
| 抄録 |
Aims: The management of jaundice and cholangitis is associated with the prognosis of the patients with unresectable hilar biliary strictures (HBS). We performed endoscopic multiple deployment of metallic stents (MS) for these patients. We evaluated the efficacy and long term outcomes of the patients receiving endoscopic multiple deployment of MS due to unresectable HBS. Methods: Between April 2004 and December 2012, 95 consecutive patients received endoscopic multiple deployment of MS using partial stent-in-stent method. If the deployment only via the transpapillary route was difficult, we used the Rendezvous technique. Sixty-six of 95 patients (69.5%) received chemotherapy after or before stent deployment. We investigated success rate, survival, MS patency, and complications. Results: Successful deployment was achieved in all patients. Nine of 95 patients (9.5 %) used the Rendezvous technique. The overall median survival time was 6.9 months, and overall median patency time was 4.6 months. There was no significant difference in the patency between the patients with and without chemotherapy. However, in the chemotherapy group, the median patency time in disease control group was significantly longer than that in progressive disease group (P=0.0012). Acute complications and MS obstruction were noted in 13 patients (13.7%) and 55 patients (57.9%), respectively. Conclusions: Endoscopic multiple deployment of MS using partial stent-in-stent method is feasible and effective for the patients with unresectable HBS. |
| 索引用語 |
metallic stent, hilar biriary stricture |
