Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study
- Author:
Koh KITAGAWA
1
;
Akira MITORO
;
Takahiro OZUTSUMI
;
Masanori FURUKAWA
;
Yukihisa FUJINAGA
;
Kenichiro SEKI
;
Norihisa NISHIMURA
;
Yasuhiko SAWADA
;
Kosuke KAJI
;
Hideto KAWARATANI
;
Hiroaki TAKAYA
;
Kei MORIYA
;
Tadashi NAMISAKI
;
Takemi AKAHANE
;
Hitoshi YOSHIJI
Author Information
- Publication Type:Original Article
- From:Clinical Endoscopy 2022;55(3):434-442
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:Covered self-expandable metallic stents (CMSs) are widely used for malignant distal biliary obstructions (MDBOs) caused by pancreatic carcinoma. This study compared the efficacy and safety of the laser-cut-type and braided-type CMSs.
Methods:To palliate MDBOs caused by pancreatic carcinoma, the laser-cut-type CMSs was used from April 2014 to March 2017, and the braided-type CMSs was used from April 2017 to March 2019. The tested self-expandable metallic stents were equipped with different anti-migration systems.
Results:In total, 47 patients received CMSs for MDBOs (24 laser-cut type, 23 braided-type). The time to recurrent biliary obstruction (TRBO) was significantly longer in the braided-type CMSs (p=0.0008), and the median time to stent dysfunction or patient death was 141 and 265 days in the laser-cut-type CMSs and braided-type CMSs, respectively (p=0.0023). Stent migration was the major cause of stent dysfunction in both groups, which occurred in 37.5% of the laser-cut-type CMSs and 13.0% of the braidedtype CMSs. There were no differences in the survival duration between the groups.
Conclusions:The TRBO was significantly longer for the braided-type CMSs with an anti-migration system than for the laser-cuttype. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.
