PMID- 36902787 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230313 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 12 IP - 5 DP - 2023 Mar 2 TI - Outcomes of Intraductal Placement of Covered Metal Stents for Unresectable Distal Malignant Biliary Obstruction. LID - 10.3390/jcm12052001 [doi] LID - 2001 AB - Intraductal self-expandable metal stent (SEMS) placement may prolong stent patency by reducing duodenobiliary reflux. This study aimed to evaluate the efficacy and safety of this biliary drainage method in patients with unresectable distal malignant biliary obstruction (MBO). Consecutive patients with unresectable MBO who underwent initial covered SEMS placement between 2015 and 2022 were retrospectively reviewed. We compared the causes of recurrent biliary obstruction (RBO), time to RBO (TRBO), adverse events (AEs), and reintervention rates between two biliary drainage methods (SEMSs placed above and across the papilla). A total of 86 patients were included (above: 38 and across: 48). Overall RBO rates (24% vs. 44%, p = 0.069) and median TRBO (11.6 months vs. 9.8 months, p = 0.189) were not significantly different between the two groups. The frequency of overall AEs was similar between the two groups in the entire cohort, but was significantly lower in patients with non-pancreatic cancer (6% vs. 44%, p = 0.035). Reintervention was successfully performed in the majority of patients in both groups. Intraductal SEMS placement was not associated with a prolonged TRBO in this study. Larger studies are warranted to further evaluate the benefit of intraductal SEMS placement. FAU - Yamada, Manabu AU - Yamada M AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. AD - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kita 761-0793, Japan. FAU - Takeda, Tsuyoshi AU - Takeda T AUID- ORCID: 0000-0002-0786-8166 AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. FAU - Sasaki, Takashi AU - Sasaki T AUID- ORCID: 0000-0001-7109-9835 AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. FAU - Okamoto, Takeshi AU - Okamoto T AUID- ORCID: 0000-0001-9719-0282 AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. FAU - Hamada, Tsuyoshi AU - Hamada T AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. AD - Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan. FAU - Ishitsuka, Takahiro AU - Ishitsuka T AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. FAU - Nakagawa, Hiroki AU - Nakagawa H AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. FAU - Mie, Takafumi AU - Mie T AUID- ORCID: 0000-0002-7561-5558 AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. FAU - Furukawa, Takaaki AU - Furukawa T AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. FAU - Kasuga, Akiyoshi AU - Kasuga A AUID- ORCID: 0000-0002-2234-1135 AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. FAU - Matsuyama, Masato AU - Matsuyama M AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. FAU - Ozaka, Masato AU - Ozaka M AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. FAU - Kobara, Hideki AU - Kobara H AUID- ORCID: 0000-0002-8508-827X AD - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kita 761-0793, Japan. FAU - Masaki, Tsutomu AU - Masaki T AD - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kita 761-0793, Japan. FAU - Sasahira, Naoki AU - Sasahira N AD - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan. LA - eng PT - Journal Article DEP - 20230302 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC10004388 OTO - NOTNLM OT - endoscopic biliary stenting OT - inside stent OT - malignant biliary obstruction OT - self-expandable metal stent COIS- T.S. has received honoraria from Boston Scientific Japan, Cook Medical Japan, SB-Kawasumi Laboratories, Century Medical, MEDICO'S HIRATA, and Zeon Medical. N.S. has received honararia from Boston Scientific Japan and Cook Medical Japan. The other authors declare no conflict of interest. EDAT- 2023/03/12 06:00 MHDA- 2023/03/12 06:01 PMCR- 2023/03/02 CRDT- 2023/03/11 01:22 PHST- 2023/01/21 00:00 [received] PHST- 2023/02/23 00:00 [revised] PHST- 2023/03/01 00:00 [accepted] PHST- 2023/03/11 01:22 [entrez] PHST- 2023/03/12 06:00 [pubmed] PHST- 2023/03/12 06:01 [medline] PHST- 2023/03/02 00:00 [pmc-release] AID - jcm12052001 [pii] AID - jcm-12-02001 [pii] AID - 10.3390/jcm12052001 [doi] PST - epublish SO - J Clin Med. 2023 Mar 2;12(5):2001. doi: 10.3390/jcm12052001.