Efficacy of multi-hole self-expandable metallic stents versus partially covered self-expandable metallic stents in patients with malignant distal biliary obstruction caused by unresectable pancreatic cancer: a retrospective comparative cohort study in Japan
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Background/Aims: This study aimed to compare the stent patency between the novel multi-hole self-expandable metallic stent (MHSEMS)and conventional partially covered SEMS (PC-SEMS) for malignant distal biliary obstruction (MDBO) in patients with pancreaticcarcinoma. Methods: This retrospective study compared stent patency between patients with MH-SEMS (n=43) and those with PC-SEMS (n=94). Secondary outcomes were overall survival (OS), incidence of recurrent biliary obstruction (RBO), causes of RBO, and adverse events(AEs). Results: The median time to RBO did not differ significantly between the MH-SEMS and PC-SEMS groups (318 vs. 460 days, p=0.17). Furthermore, the two groups did not differ significantly in terms of OS and incidence rate of AEs, including RBO and cholecystitis. RBO caused by tumor ingrowth was slightly more common in the MH-SEMS group (p=0.089). The MH-SEMS group had a slightlylower 12-month non-obstruction rate than the PC-SEMS group (33.9% vs. 60.9%). In the MH-SEMS group, stent removal was successfulin all seven patients in whom it was attempted. Conclusions: The clinical outcomes of MH-SEMS and PC-SEMS were similar in patients with MDBO caused by pancreaticcarcinomawere similar.
Abstract
Background/Aims: This study aimed to compare the stent patency between the novel multi-hole self-expandable metallic stent (MHSEMS)and conventional partially covered SEMS (PC-SEMS) for malignant distal biliary obstruction (MDBO) in patients with pancreaticcarcinoma. Methods: This retrospective study compared stent patency between patients with MH-SEMS (n=43) and those with PC-SEMS (n=94). Secondary outcomes were overall survival (OS), incidence of recurrent biliary obstruction (RBO), causes of RBO, and adverse events(AEs). Results: The median time to RBO did not differ significantly between the MH-SEMS and PC-SEMS groups (318 vs. 460 days, p=0.17). Furthermore, the two groups did not differ significantly in terms of OS and incidence rate of AEs, including RBO and cholecystitis. RBO caused by tumor ingrowth was slightly more common in the MH-SEMS group (p=0.089). The MH-SEMS group had a slightlylower 12-month non-obstruction rate than the PC-SEMS group (33.9% vs. 60.9%). In the MH-SEMS group, stent removal was successfulin all seven patients in whom it was attempted. Conclusions: The clinical outcomes of MH-SEMS and PC-SEMS were similar in patients with MDBO caused by pancreaticcarcinomawere similar.