Comparison of outcomes between secondary fully covered and uncovered self-expandable metal stents in the treatment of recurrent biliary obstruction of pancreatic cancer
Comparison of outcomes between secondary fully covered and uncovered self-expandable metal stents in the treatment of recurrent biliary obstruction of pancreatic cancer
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二次全覆膜与非覆膜自膨式金属支架治疗胰腺癌复发性胆道梗阻的疗效比较
DOI：
10.1007/s00464-021-08981-2
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发表时间：
2022
影响因子：
3.1
通讯作者：
Fujishiro Mitsuhiro
中科院分区：
文献类型：
--
作者：
Kataoka Kunio;Kawashima Hiroki;Ohno Eizaburo;Ishikawa Takuya;Mizutani Yasuyuki;Iida Tadashi;Furukawa Kazuhiro;Nakamura Masanao;Honda Takashi;Ishigami Masatoshi;Fujishiro Mitsuhiro
随着化疗技术的进步，胰腺癌（PC）的总生存期（OS）已经延长，自膨胀金属支架（SEMS）置入后复发性胆道梗阻（RBO）的病例数有望增加。我们在此比较了完全覆盖SEMS （FC）和未覆盖SEMS （UC）对PC RBO的结果，FC作为第一SEMS。方法回顾性分析2010年5月至2021年3月期间，62例接受SEMS交换到FC （n= 34）或UC （n= 28）进行RBO的PC患者。比较FC组和UC组的患者特征、OS、到RBO的时间（TRBO）和支架相关不良事件。采用Cox比例风险模型确定第二次SEMS并发RBO的危险因素。结果FC组与UC组仅在第二SEMS直径上存在显著差异。FC患者的中位OS和TRBO分别为195和238天，UC患者的中位OS和TRBO分别为306和455天，两组间无显著差异。在支架相关不良事件发生率方面没有观察到显著差异。在多变量分析中，只有第二SEMS直径具有显著性（P= 0.009）。10-mm UC、10-mm FC和8-mm UC患者的中位TRBO分别为455,238和103天，10-mm UC患者的TRBO明显长于10-mm FC和8-mm UC患者（P= 0.020和0.001）。结论以FC为第一SEMS的PC RBO可采用SEMS置换至10 mm UC。
BackgroundThe overall survival (OS) of pancreatic cancer (PC) has been prolonged by advances in chemotherapy, and the number of cases of recurrent biliary obstruction (RBO) after self-expandable metal stent (SEMS) placement is expected to increase. We herein compared outcomes between secondary fully covered SEMS (FC) and uncovered SEMS (UC) for RBO of PC with FC placed as the 1st SEMS.MethodsBetween May 2010 and March 2021, 62 PC patients who underwent SEMS exchange to FC (n= 34) or UC (n= 28) for RBO were retrospectively analyzed. Patient characteristics, OS, time to RBO (TRBO), and stent-related adverse events were compared between the FC and UC groups. Cox’s proportional hazard model was used to identify risk factors for RBO with the 2nd SEMS.ResultsThere was a significant difference between the FC and UC groups only in the 2nd SEMS diameter. Median OS and TRBO were 195 and 238 days in FC patients and 306 and 455 days in UC patients, respectively, with no significant differences between the two groups. No significant differences were observed in the stent-related adverse event rate. In multivariate analyses, only the 2nd SEMS diameter was significant (P= 0.009). Median TRBO were 455, 238, and 103 days in 10-mm UC, 10-mm FC, and 8-mm UC patients, with 10-mm UC patients having significantly longer TRBO than 10-mm FC and 8-mm UC patients (P= 0.020 and 0.001).ConclusionSEMS exchange to 10-mm UC may be appropriate for RBO of PC with FC as the 1st SEMS.
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影响因子：
7.7
作者：
Kaassis, M;Boyer, J;Burtin, P
通讯作者：
Burtin, P
影响因子：
4.1
作者：
Nakai, Yousuke;Isayama, Hiroyuki;Koike, Kazuhiko
通讯作者：
Koike, Kazuhiko
影响因子：
35.7
作者：
Philip, Philip A.;Lacy, Jill;Hammel, Pascal
通讯作者：
Hammel, Pascal
影响因子：
24.5
作者：
Isayama, H;Komatsu, Y;Omata, M
通讯作者：
Omata, M
用于治疗不可切除的恶性胆道梗阻的胆道支架置入术 用于治疗不可切除的恶性远端胆道梗阻的胆道自膨式金属支架：覆盖式还是非覆盖式，哪个更好？
DOI：
--
发表时间：
2013
期刊：
--
影响因子：
--
作者：
H. Isayama;Y. Nakai;H. Kogure;N. Yamamoto;K. Koike
通讯作者：
K. Koike