Abstract

BACKGROUND
The clinical differences between side-by-side and stent-in-stent deployment using a self-expanding metal stent for hilar malignant obstruction have not been evaluated.
AIMS
The purpose of this study was to compare the clinical features between side-by-side and stent-in-stent deployment.
METHODS
We compared side-by-side and stent-in-stent deployment in 52 consecutive patients with malignant hilar biliary obstruction who underwent endoscopic bilateral drainage using self-expanding metal stent. Side-by-side deployment (SBS group) was performed in 28 patients from 2002 to 2005, and stent-in-stent deployment (SIS group) in 24 patients from 2006 to 2010. Technical success, functional success, complications, stent occlusion and cumulative stent patency in the SBS and SIS groups were evaluated and compared retrospectively.
RESULTS
There were no significant inter-group differences in technical success (SBS vs. SIS, 89 vs. 100 %, respectively), functional success (96 vs. 100 %), early complications (11 vs. 4 %), late complications (32 vs. 8 %) or stent occlusion (20 vs. 42 %). The incidence of complications was significantly higher for SBS than for SIS (44 vs. 13 %; p = 0.016). Cumulative stent patency was significantly better for SBS than for SIS (log-rank, p = 0.047). SBS was not associated with significantly longer cumulative stent patency in univariate Cox proportional hazard analysis (HR 0.35; 95 % CI 0.12-1.03; p = 0.056) and multivariate analysis (HR 0.39; 95 % CI 0.13-1.16; p = 0.090).
CONCLUSIONS
The incidence of complications is higher for side-by-side than stent-in stent deployment in bilateral metal stenting. In terms of cumulative stent patency, side-by-side deployment tends to be more effective than stent-in-stent deployment.

Links

Publisher Full Text

Authors

Naitoh I, Hayashi K, Nakazawa T, Okumura F, Miyabe K, Shimizu S, Yoshida M, Yamashita H, Ohara H, Joh T

Institution

Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.

Source

Digestive diseases and sciences 57:12 2012 Dec pg 3279-85

MeSH

Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms
Cholestasis
Endoscopy, Gastrointestinal
Female
Humans
Male
Middle Aged
Risk Factors
Stents

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

22732832