Oncology · 2025
Duodenal Stenting Is Associated with Longer Biliary Patency in Endoscopic Ultrasound-Guided Biliary Drainage: Potential Role of Braided Biliary Stents.
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Sugimoto Mitsuru, Takagi Tadayuki, Suzuki Rei, Waragai Yuichi, Asama Hiroyuki, Shimizu Hiroshi, Sato Kentaro, Osawa Kento, Ohira Rei, Nakamura Jun, Takasumi Mika, Kato Tsunetaka, Yanagita Takumi, Otsuka Mitsuru, Hikichi Takuto, Ohira Hiromasa
Аннотация
INTRODUCTION: Recently, EUS-guided biliary drainage (EUS-BD) has been widely used as the second biliary drainage method when endoscopic transpapillary drainage fails. A longer time to recurrent biliary obstruction (TRBO) is important for biliary stenting to avoid interfering with cancer treatment. However, the factors that influence the TRBO in EUS-BD are unknown. The aim of this study was to clarify the factors associated with the TRBO in EUS-BD.
METHODS: All patients who underwent successful EUS-BD at Fukushima Medical University and Soma General Hospital were enrolled in this study. The factors associated with the TRBO were retrospectively analyzed (follow-up period: mean 215 ± standard deviation 214 days).
RESULTS: RBO was observed in 21/47 (44.7%) patients. According to the multivariate analyses, a duodenal stent before RBO was significantly associated with a longer TRBO (hazard ratio 0.34, 95% confidence interval 0.12-0.98; p = 0.045). The TRBO was also longer in patients with duodenal stents before RBO (p = 0.026) and in patients with braided biliary stents (p = 0.024). The TRBO became significantly longer according to the number of factors (p = 0.02).
CONCLUSION: Duodenal stents before RBO and braided biliary stents might be factors associated with a longer TRBO. Early duodenal stent insertion and braided biliary stent use might prevent food backflow, strongly dilate the biliary stricture, and lead to a longer TRBO.
METHODS: All patients who underwent successful EUS-BD at Fukushima Medical University and Soma General Hospital were enrolled in this study. The factors associated with the TRBO were retrospectively analyzed (follow-up period: mean 215 ± standard deviation 214 days).
RESULTS: RBO was observed in 21/47 (44.7%) patients. According to the multivariate analyses, a duodenal stent before RBO was significantly associated with a longer TRBO (hazard ratio 0.34, 95% confidence interval 0.12-0.98; p = 0.045). The TRBO was also longer in patients with duodenal stents before RBO (p = 0.026) and in patients with braided biliary stents (p = 0.024). The TRBO became significantly longer according to the number of factors (p = 0.02).
CONCLUSION: Duodenal stents before RBO and braided biliary stents might be factors associated with a longer TRBO. Early duodenal stent insertion and braided biliary stent use might prevent food backflow, strongly dilate the biliary stricture, and lead to a longer TRBO.