ID | 65905 |
フルテキストURL | |
著者 |
Matsumoto, Kazuyuki
Department of Gastroenterology and Hepatology, Okayama University Hospital
ORCID
Kaken ID
publons
Kato, Hironari
Department of Gastroenterology and Hepatology, Okayama University Hospital
ORCID
Kaken ID
researchmap
Morimoto, Kosaku
Department of Gastroenterology and Hepatology, Okayama University Hospital
Miyamoto, Kazuya
Department of Gastroenterology, Tsuyama Central Hospital
Saragai, Yosuke
Department of Gastroenterology, Iwakuni Medical Center
Kawamoto, Hirofumi
Department of General Internal Medicine 2, Kawasaki Medical School
Okada, Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Hospital
Kaken ID
publons
researchmap
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抄録 | Background/Aims: Bilateral endoscopic drainage with self-expanding metallic stent (SEMS) can be used to effectively manage hilar malignant biliary obstruction. However, the benefits of using a trisegment drainage method remain unknown.
Methods: This study retrospectively reviewed the data of 125 patients with Bismuth type IIIa or IV unresectable malignant strictures who underwent bilateral endoscopic drainage using SEMSs at four tertiary centers. The patients were divided into the bilateral and trisegment drainage groups for comparison. The primary endpoint was stent patency and the secondary endpoints were technical success, technical and clinical success of reintervention, and overall survival. Results: The technical success rates of the bilateral and trisegment drainage groups were 95% (34/36) and 90% (80/89) (p=0.41), respectively, with median stent patency durations of 226 and 170 days (p=0.26), respectively. Although the technical success of reintervention was not significantly different between the two groups (p=0.51), the clinical success rate of reintrvention was significantly higher in the trisegment drainage group (73% [11/15] vs 96% [47/49], p=0.009). The median survival times were 324 and 323 days in the bilateral and trisegment drainage groups, respectively (p=0.72). Multivariate Cox hazards model revealed no stent patency-associated factor; however, chemotherapy was associated with longer survival. Conclusions: Although no significant difference was noted with respect to stent patency, significantly higher clinical success rates were achieved with reintervention using the trisegment drainage method than using the bilateral drainage method alone. |
キーワード | Bile duct obstruction
Neoplasms
Endoscopic biliary drainage
Bilateral drainage
Self-expandable metallic stents
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発行日 | 2022-07-19
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出版物タイトル |
Gut and Liver
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巻 | 17巻
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号 | 1号
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出版者 | The Editorial Office of Gut and Liver
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開始ページ | 170
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終了ページ | 178
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ISSN | 1976-2283
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NCID | AA12329814
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資料タイプ |
学術雑誌論文
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言語 |
英語
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OAI-PMH Set |
岡山大学
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著作権者 | © Gut and Liver.
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論文のバージョン | publisher
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PubMed ID | |
DOI | |
Web of Science KeyUT | |
関連URL | isVersionOf https://doi.org/10.5009/gnl220012
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ライセンス | http://creativecommons.org/licenses/by-nc/4.0
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Citation | Matsumoto K, Kato H, Morimoto K, Miyamoto K, Saragai Y, Kawamoto H, Okada H. Comparison of Bilateral and Trisegment Drainage in Patients with High-Grade Hilar Malignant Biliary Obstruction: A Multicenter Retrospective Study. Gut and Liver 2023;17:170-178. https://doi.org/10.5009/gnl220012
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