Antireflux Metal Stent for Initial Treatment of Malignant Distal Biliary Obstruction
Objectives. To compare the use of an antireflux metal stent (ARMS) with that of a conventional covered self-expandable metal stent (c-CSEMS) for initial stenting of malignant distal biliary obstruction (MDBO). Materials and Methods. We retrospectively investigated 59 consecutive patients with unrese...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/3805173 |
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| author | Shinichi Morita Yasuaki Arai Shunsuke Sugawara Miyuki Sone Yasunari Sakamoto Takuji Okusaka Shigetaka Yoshinaga Yutaka Saito Shuji Terai |
| author_facet | Shinichi Morita Yasuaki Arai Shunsuke Sugawara Miyuki Sone Yasunari Sakamoto Takuji Okusaka Shigetaka Yoshinaga Yutaka Saito Shuji Terai |
| author_sort | Shinichi Morita |
| collection | DOAJ |
| description | Objectives. To compare the use of an antireflux metal stent (ARMS) with that of a conventional covered self-expandable metal stent (c-CSEMS) for initial stenting of malignant distal biliary obstruction (MDBO). Materials and Methods. We retrospectively investigated 59 consecutive patients with unresectable MDBO undergoing initial endoscopic biliary drainage. ARMS was used in 32 patients and c-CSEMS in 27. Technical success, functional success, complications, causes of recurrent biliary obstruction (RBO), time to RBO (TRBO), and reintervention were compared between the groups. Results. Stent placement was technically successful in all patients. There were no significant intergroup differences in functional success (ARMS [96.9%] versus c-CSEMS [96.2%]), complications (6.2 versus 7.4%), and RBO (48.4 versus 42.3%). Food impaction was significantly less frequent for ARMS than for c-CSEMS (P=0.037), but TRBO did not differ significantly between the groups (log-rank test, P=0.967). The median TRBO was 180.0 [interquartile range (IQR), 114.0–349.0] days for ARMS and 137.0 [IQR, 87.0–442.0] days for c-CSEMS. In both groups, reintervention for RBO was successfully completed in all patients thus treated. Conclusion. ARMS offers no advantage for initial stent placement, but food impaction is significantly prevented by the antireflux valve. |
| format | Article |
| id | doaj-art-69d05f79083b4688985e73bf6b0f7122 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-69d05f79083b4688985e73bf6b0f71222025-02-03T05:46:31ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/38051733805173Antireflux Metal Stent for Initial Treatment of Malignant Distal Biliary ObstructionShinichi Morita0Yasuaki Arai1Shunsuke Sugawara2Miyuki Sone3Yasunari Sakamoto4Takuji Okusaka5Shigetaka Yoshinaga6Yutaka Saito7Shuji Terai8Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Hospital, 4132 Urasa, Minamiuonuma, Niigata 949-7302, JapanDepartment of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanDepartment of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanDepartment of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanDepartment of Hepatology and Pancreatobiliary Internal Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanDepartment of Hepatology and Pancreatobiliary Internal Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanEndoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanEndoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, JapanDepartment of Gastroenterology and Hepatology, Niigata University Hospital, 754 Ichibancho, Asahimachidori, Chuo-ku, Niigata city, Niigata 951-8510, JapanObjectives. To compare the use of an antireflux metal stent (ARMS) with that of a conventional covered self-expandable metal stent (c-CSEMS) for initial stenting of malignant distal biliary obstruction (MDBO). Materials and Methods. We retrospectively investigated 59 consecutive patients with unresectable MDBO undergoing initial endoscopic biliary drainage. ARMS was used in 32 patients and c-CSEMS in 27. Technical success, functional success, complications, causes of recurrent biliary obstruction (RBO), time to RBO (TRBO), and reintervention were compared between the groups. Results. Stent placement was technically successful in all patients. There were no significant intergroup differences in functional success (ARMS [96.9%] versus c-CSEMS [96.2%]), complications (6.2 versus 7.4%), and RBO (48.4 versus 42.3%). Food impaction was significantly less frequent for ARMS than for c-CSEMS (P=0.037), but TRBO did not differ significantly between the groups (log-rank test, P=0.967). The median TRBO was 180.0 [interquartile range (IQR), 114.0–349.0] days for ARMS and 137.0 [IQR, 87.0–442.0] days for c-CSEMS. In both groups, reintervention for RBO was successfully completed in all patients thus treated. Conclusion. ARMS offers no advantage for initial stent placement, but food impaction is significantly prevented by the antireflux valve.http://dx.doi.org/10.1155/2018/3805173 |
| spellingShingle | Shinichi Morita Yasuaki Arai Shunsuke Sugawara Miyuki Sone Yasunari Sakamoto Takuji Okusaka Shigetaka Yoshinaga Yutaka Saito Shuji Terai Antireflux Metal Stent for Initial Treatment of Malignant Distal Biliary Obstruction Gastroenterology Research and Practice |
| title | Antireflux Metal Stent for Initial Treatment of Malignant Distal Biliary Obstruction |
| title_full | Antireflux Metal Stent for Initial Treatment of Malignant Distal Biliary Obstruction |
| title_fullStr | Antireflux Metal Stent for Initial Treatment of Malignant Distal Biliary Obstruction |
| title_full_unstemmed | Antireflux Metal Stent for Initial Treatment of Malignant Distal Biliary Obstruction |
| title_short | Antireflux Metal Stent for Initial Treatment of Malignant Distal Biliary Obstruction |
| title_sort | antireflux metal stent for initial treatment of malignant distal biliary obstruction |
| url | http://dx.doi.org/10.1155/2018/3805173 |
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