Unilateral versus bilateral Y-type stent-in-stent metal stent insertions in inoperable malignant hilar biliary strictures:A multicenter retrospective study

作     者：Ik Hyun Jo Chang-Nyol Paik Dae Bum Kim Jaesin Lee Jong Yul Lee Jae Hyuck Chang Kyu-Hyun Paik Won-Suk Park Ik Hyun Jo;Chang-Nyol Paik;Dae Bum Kim;Jaesin Lee;Jong Yul Lee;Jae Hyuck Chang;Kyu-Hyun Paik;Won-Suk Park

作者机构：Department of Internal MedicineCollege of MedicineSt.Vincent’s HospitalThe Catholic University of KoreaSeoulKorea Department of Internal MedicineCollege of MedicineIncheon St.Mary’s HospitalThe Catholic University of KoreaSeoulKorea Department of Internal MedicineCollege of MedicineBucheon St.Mary’s HospitalThe Catholic University of KoreaSeoulKorea Department of Internal MedicineCollege of MedicineDaejeon St.Mary’s HospitalThe Catholic University of KoreaSeoulKorea 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2021年第20卷第6期

页      面：561-567页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Catholic University of Korea  CUK  (XC20RIDI0095) 

主　　题：Cholestasis Extrahepatic neoplasm Cholangiopancreatography Endoscopy Self-expandable metal stents 

摘      要：Background:To date,there is controversy regarding unilateral versus bilateral stent placement in patients with malignant hilar biliary strictures(MHBSs).The aim of this study was to compare the clinical outcomes and complications of unilateral and bilateral(stent-in-stent method)stent placements for these ***:We conducted a multicenter retrospective analysis of patients with inoperable MHBS who underwent endoscopic self-expandable metal stent(SEMS)placement from January 2009 to December *** groups classified according to the stent procedure method were compared for demographic,procedural,and postprocedure *** analysis for patency loss and overall survival was also ***:A total of 236 subjects were included.A superior technical success rate was found in the unilateral stent group(98.8%vs.82.5%,P0.001),whereas the clinical success rate was higher in the bilateral group(85.7%vs.70.5%,P=0.028).There was no significant difference with respect to complications or patency loss,and the bilateral group had better overall survival(P0.01).In the Cox proportional hazard model,MHBSs from lymph node compression were associated with a higher risk of death(HR=9.803,P=0.003).In contrast,bilateral SEMS insertion showed reduced postprocedural mortality(HR=0.316,P=0.001).Conclusions:Y-type stent-in-stent bilateral SEMSs are technically difficult but demonstrated more favorable overall survival for palliative bile drainage of inoperable MHBS patients compared to unilateral insertions.