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Tumor invasion to the arteries feeding the gallbladder as a novel risk factor for cholecystitis after metallic stent placement in distal malignant biliary obstruction
Author(s) -
Sogabe Yuko,
Kodama Yuzo,
Honjo Hajime,
Aoyama Ikuo,
Muramoto Yuya,
Koga Eri,
Yanaidani Takafumi,
Kawai Munenori,
Yoshikawa Teppei,
Matsumoto Shimpei,
Matsumoto Astushi,
Mori Yoshiharu,
Ono Chikage,
Nishida Miyu,
Nishida Yoshihiro,
Mikami Takao,
Matsunaga Yasuhiro,
Miyamoto Yukiko,
Kitami Motoya,
Nishikawa Koji,
Kondo Masahiko,
Miyake Naoki,
Kawanami Chiharu,
Seno Hiroshi
Publication year - 2018
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12991
Subject(s) - medicine , cholecystitis , gallbladder , bile duct , self expandable metallic stent , univariate analysis , stent , odds ratio , cystic artery , gastroenterology , cystic duct , surgery , radiology , multivariate analysis
Background and Aim Cholecystitis is a major complication after self‐expandable metallic stent ( SEMS ) placement for malignant biliary obstruction. Ischemia is one of the risk factors for cholecystitis, but little is known about the influence of tumor invasion to the feeding artery of the gallbladder on the onset of cholecystitis after SEMS placement. The aim of the present study was to identify risk factors for cholecystitis after SEMS placement. Methods Incidence and nine predictive factors of cholecystitis were retrospectively evaluated in 107 patients who underwent SEMS placement for unresectable distal malignant biliary obstruction at Kyoto University Hospital and Otsu Red Cross Hospital between January 2012 and June 2016. Results Cholecystitis occurred in 13 of 107 patients (12.1%) after SEMS placement during the median follow‐up period of 262 days. Univariate analyses showed that tumor invasion to the feeding artery of the gallbladder and tumor involvement to the orifice of the cystic duct were significant predictors of cholecystitis ( P = 0.001 and P < 0.001). Multivariate analysis confirmed that these two factors were significant and independent risks for cholecystitis with odds ratios of 22.13 (95% CI , 3.57–137.18; P = 0.001) and 25.26 (95% CI , 4.12–154.98; P < 0.001), respectively. Conclusions This study showed for the first time that tumor invasion to the feeding artery of the gallbladder as well as tumor involvement to the orifice of the cystic duct are independent risk factors for cholecystitis after SEMS placement.