Zuniga Cisneros Julio, Mc-Kenzie Alexis, Ramos Ivan, Ortiz Eric, Quiros Orlando, Duarte-Chang Calixto, Tunon Carlos
Department of Gastroenterology, Instituto Oncologico de Panama, Panama City, Panama.
School of Medicine, University of Panama, Panama, Panama City, Panama.
Gastroenterology Res. 2025 Jun 16;18(4):192-201. doi: 10.14740/gr2046. eCollection 2025 Aug.
Endoscopic biliary drainage has emerged as the standard treatment for palliative drainage in malignant biliary strictures (MBS).
This prospective study aimed to investigate the outcomes of patients diagnosed with MBS who underwent biliary drainage through endoscopic retrograde cholangiopancreatography (ERCP) at Complejo Hospitalario Metropolitano. The primary goals were to evaluate the stent dysfunction (SD) and mortality over a 12-month follow-up period. We evaluated the technical and functional deployment success rates according to the stricture location and type of stent used.
Out of 191 patients screened, 147 were eligible for inclusion. Distal strictures exhibited significantly higher technical (96.3%) and functional (75.8%) success deployment rates compared to hilar strictures (32.4% technical, 58.8% functional). The overall incidence of SD reached 46.9%, while mortality was 43.5%. Notably, complications varied by stricture type, with bacteremia predominating in hilar stricture cases.
The findings from our prospective study affirm a commendably high rate of successful endoscopic stenting interventions along with a lower incidence of adverse events in patients suffering from MBS. Conversely, it is imperative to acknowledge that the endoscopic management of malignant hilar strictures necessitates a more individualized approach due to the elevated complication rates and increased likelihood of SD observed in our study.
内镜下胆道引流已成为恶性胆管狭窄（MBS）姑息性引流的标准治疗方法。
这项前瞻性研究旨在调查在大都会综合医院通过内镜逆行胰胆管造影术（ERCP）进行胆道引流的MBS患者的治疗结果。主要目标是评估12个月随访期内的支架功能障碍（SD）和死亡率。我们根据狭窄部位和所用支架类型评估了技术和功能置入成功率。
在191例筛查患者中，147例符合纳入标准。与肝门部狭窄相比，远端狭窄的技术成功率（96.3%）和功能成功率（75.8%）显著更高（技术成功率32.4%，功能成功率58.8%）。SD的总体发生率达到46.9%，死亡率为43.5%。值得注意的是，并发症因狭窄类型而异，肝门部狭窄病例中菌血症占主导。
我们前瞻性研究的结果证实，MBS患者内镜支架置入干预的成功率高，不良事件发生率低，值得称赞。相反，必须认识到，由于我们的研究中观察到肝门部恶性狭窄的并发症发生率升高和SD可能性增加，对其进行内镜治疗需要更个体化的方法。
