MISC

2015年2月

Endoscopic inside stent placement is suitable as a bridging treatment for preoperative biliary tract cancer

BMC GASTROENTEROLOGY
  • Noritoshi Kobayashi
  • Seitaro Watanabe
  • Kunihiro Hosono
  • Kensuke Kubota
  • Atsushi Nakajima
  • Takashi Kaneko
  • Kazuya Sugimori
  • Motohiko Tokuhisa
  • Ayumu Goto
  • Ryutaro Mori
  • Koichi Taniguchi
  • Ryusei Matsuyama
  • Itaru Endo
  • Shin Maeda
  • Yasushi Ichikawa
  • 全て表示

15
記述言語
英語
掲載種別
DOI
10.1186/s12876-015-0233-2
出版者・発行元
BIOMED CENTRAL LTD

Background: Endoscopic biliary stenting (EBS) is one of the most important palliative treatments for biliary tract cancer. However, reflux cholangitis arising from bacterial adherence to the inner wall of the stent must be avoided. We evaluated the use of EBS above the sphincter of Oddi to determine whether reflux cholangitis could be prevented in preoperative cases.
Methods: Fifty-seven patients with primary biliary tract cancer were retrospectively recruited for the evaluation of stent placement either above (n = 25; inside stent group) or across (n = 32; conventional stent group) the sphincter of Oddi. We compared the stent patency periods prior to the time of surgical resection.
Results: The preoperative periods were 96.3 days in the conventional stent group and 96.8 days in the inside stent group (P = 0.979). Obstructive jaundice and/or acute cholangitis occurred in 7 patients (28.0%) in the inside stent group and in 15 patients (46.9%) in the conventional stent group during the preoperative period (P = 0.150). The average patency periods of the stents were 85.2 days (range, 13-387 days) for the inside stent group and 49.1 days (range, 9-136 days) for the conventional stent group (log-rank test: P = 0.009). The mean numbers of re-interventions because of stent occlusion were 0.32 for the inside stent group and 1.03 for the conventional stent group (P = 0.026). Post-endoscopic retrograde cholangiopancreatography complications occurred in 2 patients in the inside stent group and 4 patients in the conventional stent group (P = 0.516). Postoperative liver abscess occurred in 1 patient in the inside stent group and 5 patients in the conventional stent group (P = 0.968). Inside stent placement was the only significant preventative factor associated with stent obstruction based on univariate (hazard ratio [HR], 0.286; 95% confidence interval [CI], 0.114-0.719; P = 0.008) and multivariate (HR, 0.292; 95% CI, 0.114-0.750; P = 0.011) analyses.
Conclusion: Temporary plastic stent placement above the sphincter of Oddi is a better bridging treatment than conventional stent placement in preoperative primary biliary tract cancer.

リンク情報
DOI
https://doi.org/10.1186/s12876-015-0233-2
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000349122000001&DestApp=WOS_CPL
URL
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84923914745&origin=inward
ID情報
  • DOI : 10.1186/s12876-015-0233-2
  • ISSN : 1471-230X
  • SCOPUS ID : 84923914745
  • Web of Science ID : WOS:000349122000001

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