Kikuyama Masataka, Shirane Naofumi, Kawaguchi Shinya, Terada Shuzou, Mukai Tsuyoshi, Sugimoto Ken
Department of Gastroenterology, Komagome Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan.
World J Gastrointest Endosc. 2018 Jan 16;10(1):16-22. doi: 10.4253/wjge.v10.i1.16.
To investigate whether an uncovered self-expandable metal stent (UCSEMS) with a large diameter could prevent recurrent biliary obstruction (RBO).
Thirty-eight patients with malignant biliary obstruction underwent treatment with an UCSEMS with a 14-mm diameter (Niti-S 14). Retrospectively, we evaluated technical and functional success rate, RBO rate, time to RBO, survival time, and adverse events in these patients.
Stent placement success and functional success were achieved in all patients. Two patients (5.3%) had RBO due to tumor ingrowth or overgrowth. The median time to RBO was 190 (range, 164-215) d. The median survival time was 120 (range, 18-502) d. The 6-mo non-RBO rate was 91%. Other adverse events other than RBO occurred as follows: Acute cholecystitis, post-ERCP pancreatitis, hemobilia, and fever without exacerbation of liver injury, and liver abscess in 4 (10.3%), 3 (7.9%), 2 (5.3%), 1 (2.6%), and 1 (2.6%), respectively. Migration of the stents was not observed.
Niti-S 14 is considered to be a preferable metal stent because of a low rate of RBO with no migration.
探讨大直径无覆膜自膨式金属支架（UCSEMS）能否预防复发性胆道梗阻（RBO）。
38例恶性胆道梗阻患者接受了直径14mm的UCSEMS（Niti-S 14）治疗。我们回顾性评估了这些患者的技术成功率、功能成功率、RBO发生率、发生RBO的时间、生存时间及不良事件。
所有患者均成功置入支架且功能良好。2例患者（5.3%）因肿瘤长入或过度生长发生RBO。发生RBO的中位时间为190天（范围164 - 215天）。中位生存时间为120天（范围18 - 502天）。6个月时无RBO发生率为91%。除RBO外的其他不良事件发生情况如下：急性胆囊炎、内镜逆行胰胆管造影术后胰腺炎、胆道出血、未加重肝损伤的发热以及肝脓肿，分别有4例（10.3%）、3例（7.9%）、2例（5.3%）、1例（2.6%）和1例（2.6%）。未观察到支架移位。
Niti-S 14被认为是一种较好的金属支架，因为其RBO发生率低且无移位。
