Outcome of self-expandable metallic stents in low-grade versus advanced hilar obstruction

Journal of Gastroenterology and Hepatology
Rungsun RerknimitrPinit Kullavanijaya

Abstract

Self-expandable metallic stents (SEMS) are known to provide a longer patency time than plastic stents for malignant biliary obstructions including hilar obstruction. However, studies that focus on the efficacy of SEMS in low-grade and advanced hilar obstructions are still scanty. Ninety four patients with malignant hilar obstructions were enrolled (six were later excluded). Patients were divided into two groups according to their Bismuth levels. Group A were patients with Bismuth I (n = 53). Group B were patients with Bismuth II, III and IV (n = 35). Technical success, complications, jaundice resolution, stent patency time, and patients' survival were analyzed. Our intention-to-treat analysis showed that group A had a significant lower rate of post-endoscopic retrograde cholangiopancreatography (ERCP) cholangitis than group B; 16.1% versus 44.7%, (P < 0.01). Four patients from group B still had persistent jaundice. Our per protocol analysis demonstrated that median stent patency time in groups A and B were not statistically different (74 vs 60 days). Median survival time in groups A and B were also not statistically different (90 vs 75 days). In both groups, those without liver metastasis had significantly better patency and su...Continue Reading

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Citations

Feb 24, 2010·Surgical Endoscopy·Wiriyaporn RidtitidPinit Kullavanijaya
Feb 22, 2012·Journal of Vascular and Interventional Radiology : JVIR·Dong Il GwonKyu-Bo Sung
May 25, 2012·World Journal of Gastrointestinal Endoscopy·Wiriyaporn Ridtitid, Rungsun Rerknimitr
Apr 18, 2019·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Pradermchai KongkamRungsun Rerknimitr
Oct 12, 2010·Expert Review of Gastroenterology & Hepatology·Muslim AtiqJeffrey H Lee
Dec 14, 2011·Expert Review of Gastroenterology & Hepatology·Sathya Jaganmohan, Jeffrey H Lee

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