2.Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study
Koh KITAGAWA ; 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
Clinical Endoscopy 2022;55(3):434-442
		                        		
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
            
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