Do Min Young, Jang Sung Ill, Cho Jae Hee, Kim Yonsoo, Kim In-Jung, Lee Kwang-Hun, Joo Seung-Moon, Lee Dong Ki
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea.
Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea.
J Clin Med. 2022 May 30;11(11):3092. doi: 10.3390/jcm11113092.
Self-expandable metallic stents (SEMSs) are typically inserted in patients with unresectable malignant biliary obstruction. However, SEMSs are susceptible to occlusion. To overcome this issue, we developed a large-bore, dumbbell-shaped, fully covered SEMS (FCSEMS-L) and compared its efficacy and safety with those of a conventional FCSEMS (FCSEMS-C) in patients with malignant biliary obstruction.
Patients with unresectable distal malignant biliary obstruction were retrospectively enrolled between January 2011 and February 2021. All patients underwent endoscopic insertion of FCSEMSs. Recurrent biliary obstruction (RBO), patient survival time, complications, and prognosis were analyzed.
RBO occurred in 31 patients (35.6%) who received an FCSEMS-L, and in 34 (45.9%) who received an FCSEMS-C. Stent occlusion occurred in 19 patients (21.8%) who received an FCSEMS-L, and in 22 (29.7%) who received an FCSEMS-C. Stent migration occurred in 12 patients (13.8%) with an FCSEMS-L and 12 (16.2%) with an FCSEMS-C. The median time to RBO (TRBO) was 301 days with an FCSEMS-L and 203 days with an FCSEMS-C. The median survival time was 479 days with an FCSEMS-L and 523 days with an FCSEMS-C. The TRBO and patient survival time did not significantly differ between the two groups.
There were no significant differences in efficacy and complication rates between the fully covered large bore SEMSs and conventional fully covered SEMSs.
自膨式金属支架（SEMS）通常用于不可切除的恶性胆管梗阻患者。然而，SEMS易发生阻塞。为克服这一问题，我们研发了一种大口径、哑铃形、全覆膜SEMS（FCSEMS-L），并在恶性胆管梗阻患者中比较了其与传统全覆膜SEMS（FCSEMS-C）的疗效和安全性。
回顾性纳入2011年1月至2021年2月期间不可切除的远端恶性胆管梗阻患者。所有患者均接受了FCSEMS的内镜置入。分析复发性胆管梗阻（RBO）、患者生存时间、并发症和预后情况。
接受FCSEMS-L的31例患者（35.6%）发生RBO，接受FCSEMS-C的34例患者（45.9%）发生RBO。接受FCSEMS-L的19例患者（21.8%）发生支架阻塞，接受FCSEMS-C的22例患者（29.7%）发生支架阻塞。接受FCSEMS-L的12例患者（13.8%）发生支架移位，接受FCSEMS-C的12例患者（16.2%）发生支架移位。FCSEMS-L组RBO的中位时间（TRBO）为301天，FCSEMS-C组为203天。FCSEMS-L组的中位生存时间为479天，FCSEMS-C组为523天。两组间的TRBO和患者生存时间无显著差异。
全覆膜大口径SEMS与传统全覆膜SEMS在疗效和并发症发生率方面无显著差异。
