| 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 |
|---|---|
| タイトル | 内IS6-8：Risk factors for stent dysfunction following multiple placement of metal stents in malignant hilar biliary obstruction |
| 演者 | Y. Kanno（Sendai City Medical Center） |
| 共同演者 | N. Fujita（Sendai City Medical Center） |
| 抄録 | Aims: Endoscopic multiple SEMS placement (multi-MS) for malignant hilar biliary obstruction (mHBO) has been widely performed recently. The aim of this study was to investigate risk factors for dysfunction of such SEMSs placed in the hilum. Methods: Fifty-one patients with mHBO who had undergone multi-MS in a partial stent-in-stent manner were recruited. In univariate analysis, risk factors for dysfunction were estimated by the log-rank test with the cumulative dysfunction rate on the Kaplan-Meier method (KM) and by the Fisher's exact test with the dysfunction rate at 180 days after the intervention (FT180). Factors investigated were age, sex, etiology, endoscopic sphincterotomy, use of an SEMS with only large cells, transpapillary stenting, chemotherapy, and so on. Results: During a mean follow-up of 179 days, the median time to dysfunction was 209 days. The dysfunction rate at 180 days was 48% (14/29). Univariate analysis with the KM revealed that gallbladder cancer was a risk for dysfunction (P=.022). Univariate analysis by the FT180 indicated that age under 75 years (P=.095), male (P=.042), and NO chemotherapy (P=.070) were the risks. Multivariate analysis showed that age under 75 years (P=.018) and no chemotherapy (P=.010) were the independent risks. Conclusions: In patients who underwent multi-MS for mHBO, gallbladder cancer was the only risk factor for cumulative stent dysfunction. Age over 75 years and receiving chemotherapy were negative risks for dysfunction at 180 days after the intervention. |
| 索引用語 | Hilar obstruction, Multi-stenting |