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Feasibility of one‐step endoscopic metal stenting for distal malignant biliary obstruction
Author(s) -
Shimizu Shuya,
Naitoh Itaru,
Nakazawa Takahiro,
Hayashi Kazuki,
Miyabe Katsuyuki,
Kondo Hiromu,
Yoshida Michihiro,
Yamashita Hiroaki,
Ohara Hirotaka,
Joh Takashi
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.22
Subject(s) - medicine , biliary drainage , stent , drainage , bilirubin , surgery , self expandable metallic stent , incidence (geometry) , gastroenterology , ecology , physics , optics , biology
Background We aimed to clarify the clinical usefulness of one‐step self‐expandable metal stent ( SEMS) placement for distal malignant biliary obstruction by comparing with two‐step SEMS placement. Methods We retrospectively compared early complications, bilirubin level decreasing rate, and period of hospitalization between 40 patients with one‐step SEMS and 52 patients with two‐step SEMS . We also evaluated the complications in patients with two‐step SEMS by classifying them into first drainage ( ERBD or ENBD ) and second drainage ( SEMS ). Results The total incidence of early complications was significantly higher in patients with one‐step SEMS than the second drainage of two‐step SEMS (42.5% [17/40] vs. 13.5% [7/52]; P = 0.004). However, there was no significant difference in the early complications between one‐step SEMS and two‐step SEMS (total of first and second drainage) (42.5% [17/40] vs. 36.5% [19/52]; P = 0.561). The period required to reach the bilirubin level (<3 mg/dL) after initial drainage was significantly shorter in one‐step SEMS than in two‐step SEMS (5.7 vs. 10.1 days; P = 0.025). Similar results were observed in the period of hospitalization for patients without chemotherapy (22.2 vs. 37.3 days; P = 0.004).Conclusions One‐step SEMS placement is the alternative option of drainage method for distal malignant biliary obstruction.