| International Session (Workshop) 2 (JGES・JSGE・JSGS) |
| Sat. November 3rd 14:40 - 17:00 Room 13: Kobe International Conference Center International Conference Room |
| Comparison between inside plastic stent and metallic stent-in-stent placement for malignant hilar biliary obstruction: initial and re-intervention outcomes | |||
| Toshifumi Kin1, Akio Katanuma1, Kuniyuki Takahashi1 | |||
| 1Center for Gastroenterology, Teine-Keijinkai Hospital | |||
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| Aim To compare the initial results and re-intervention outcomes after recurrent biliary obstruction (RBO) of inside plastic stenting (IS) and metallic stent placement using stent-in-stent method (MS-SIS) and for malignant hilar biliary obstruction (MHBO). Methods Patients who underwent MS-SIS (MS group) or IS (IS group) as an initial drainage for unresectable MHBO between April 2010 and December 2017 were analyzed retrospectively. This study defined successful endoscopic management on re-intervention as stent exchange after IS or plastic stent placement into metallic stent after MS-SIS. Results This study included 34 and 19 in IS and MS group, respectively. Their Bismuth-Corlette classifications were II/III/IV in 11/10/13 of IS group and 12/5/2 of MS group. Estimated 50% times to RBO (TRBO) were 129 days in IS group and 120 days in MS group. As for re-intervention, 25 and 18 procedures were performed to 13 patients in IS group and 7 patients in MS group, respectively. Their median procedural times were 20 (range, 9-44) minutes in IS group and 26 (range, 10-56) in MS group, which showed significant difference (p=0.04). Their 50% TRBOs after re-intervention were 140 days in IS group and 53 days in MS group, which showed significant difference (p=0.002). Estimated 50% times of successful endoscopic management including re-intervention achieved 312 days in IS group and 260 days in MS group, which showed no significant difference between them. Conclusion The period of successful endoscopic management did not differ between the groups. Considering that the procedural time for re-intervention was shorter and TRBO after re-intervention was longer in IS, endoscopic management to MHBO with IS might be easier than that with MS-SIS. |
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Index Term 1: malignant hilar biliary obstruction Index Term 2: re-intervention |
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