Clinical Endoscopy (May 2022)

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

DOI
https://doi.org/10.5946/ce.2021.161
Journal volume & issue
Vol. 55, no. 3
pp. 434 – 442

Abstract

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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 braided-type 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-cut-type. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.

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