Percutaneous Transhepatic Biliary Metal Stent for Malignant Hilar Obstruction: Results and Predictive Factors for Efficacy in 159 Patients from a ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-10-24

AUTHORS

Mingwu Li, Ming Bai, Xingshun Qi, Kai Li, Zhanxin Yin, Jianhong Wang, Wenbing Wu, Luanluan Zhen, Chuangye He, Daiming Fan, Zhuoli Zhang, Guohong Han

ABSTRACT

AimTo investigate and compare the efficacy and safety of percutaneous transhepatic biliary stenting (PTBS) using a one- or two-stage procedure and determine the predictive factors for the efficacious treatment of malignant hilar obstruction (MHO).Methods159 consecutive patients with MHO who underwent PTBS were enrolled between January 2010 and June 2013. Patients were classified into one- or two-stage groups. Independent predictors of therapeutic success were evaluated using a logistic regression model.Results108 patients were treated with one-stage PTBS and 51 patients were treated with two-stage PTBS. The stents were technically successful in all patients. Successful drainage was achieved in 114 patients (71.4 %). A total of 42 early major complications were observed. Re-interventions were attempted in 23 patients during follow-up. The cumulative primary patency rates at 3, 6, and 12 months were 88, 71, and 48 %, respectively. Stent placement using a one- or two-stage procedure did not significantly affect therapeutic success, early major complications, median stent patency, or survival. A stent placed across the duodenal papilla was an independent predictor of therapeutic success (odds ratio = 0.262, 95 % confidence interval [0.107–0.642]). Patients with stents across papilla had a lower rate of cholangitis compared with patients who had a stent above papilla (7.1 vs. 20.3 %, respectively, p = 0.03).ConclusionsThe majority of patients with MHO who underwent one-stage PTBS showed similar efficacy and safety outcomes compared with those who underwent two-stage PTBS. Stent placement across the duodenal papilla was associated with a higher therapeutic success rate. More... »

PAGES

709-721

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00270-014-0992-0

DOI

http://dx.doi.org/10.1007/s00270-014-0992-0

DIMENSIONS

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PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25338831


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28 schema:description AimTo investigate and compare the efficacy and safety of percutaneous transhepatic biliary stenting (PTBS) using a one- or two-stage procedure and determine the predictive factors for the efficacious treatment of malignant hilar obstruction (MHO).Methods159 consecutive patients with MHO who underwent PTBS were enrolled between January 2010 and June 2013. Patients were classified into one- or two-stage groups. Independent predictors of therapeutic success were evaluated using a logistic regression model.Results108 patients were treated with one-stage PTBS and 51 patients were treated with two-stage PTBS. The stents were technically successful in all patients. Successful drainage was achieved in 114 patients (71.4 %). A total of 42 early major complications were observed. Re-interventions were attempted in 23 patients during follow-up. The cumulative primary patency rates at 3, 6, and 12 months were 88, 71, and 48 %, respectively. Stent placement using a one- or two-stage procedure did not significantly affect therapeutic success, early major complications, median stent patency, or survival. A stent placed across the duodenal papilla was an independent predictor of therapeutic success (odds ratio = 0.262, 95 % confidence interval [0.107–0.642]). Patients with stents across papilla had a lower rate of cholangitis compared with patients who had a stent above papilla (7.1 vs. 20.3 %, respectively, p = 0.03).ConclusionsThe majority of patients with MHO who underwent one-stage PTBS showed similar efficacy and safety outcomes compared with those who underwent two-stage PTBS. Stent placement across the duodenal papilla was associated with a higher therapeutic success rate.
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35 ConclusionsThe majority
36 biliary metal stents
37 biliary stenting
38 center
39 cholangitis
40 complications
41 consecutive patients
42 cumulative primary patency rate
43 drainage
44 duodenal papilla
45 early major complications
46 efficacious treatment
47 efficacy
48 factors
49 group
50 high therapeutic success rate
51 hilar obstruction
52 independent predictors
53 logistic regression models
54 lower rates
55 major complications
56 majority
57 malignant hilar obstruction
58 median stent patency
59 metal stents
60 model
61 months
62 obstruction
63 outcomes
64 papillae
65 patency
66 patency rates
67 patients
68 percutaneous transhepatic biliary stenting
69 placement
70 predictive factors
71 predictors
72 primary patency rate
73 procedure
74 rate
75 regression models
76 results
77 safety
78 safety outcomes
79 similar efficacy
80 single center
81 stent patency
82 stent placement
83 stenting
84 stents
85 success
86 success rate
87 successful drainage
88 survival
89 therapeutic success
90 therapeutic success rate
91 total
92 treatment
93 two-stage group
94 two-stage procedure
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