Endoscopic revision efficacy after clinically successful bilateral metal stenting for advanced malignant hilar obstruction

Tae Hoon Lee, Sung Ill Jang, Jong Ho Moon, Yun Nah Lee, Jae Kook Yang, Jin Seok Park, Seok Jeong, Don Haeng Lee, Nam Hun Heo, Sang Heum Park, Dong Ki Lee

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Backgrounds and Aim: Multiple insertions of self-expandable metal stents (SEMS) for advanced malignant hilar obstruction (MHO) are now considered to be an effective palliative method for adequate drainage of liver volume. However, the efficacy of endoscopic reintervention in technically and clinically successful bilateral SEMS is limited. This study investigated the endoscopic revision efficacy in patients who underwent bilateral SEMS in MHO. Methods: Primary endoscopic revision using plastic or metal stents or an alternative percutaneous approach followed by secondary endoscopic revision was performed in patients who underwent clinically successful deployment of bilateral SEMS. The primary outcome was a technical success. Secondary outcomes were clinical success, adverse events, and patency duration after reintervention. Results: A total of 55 patients (83.3%) out of 66 enrolled patients underwent reintervention: primary endoscopic reintervention (n = 47) and secondary endoscopic revision following percutaneous drainage (n = 8). Intended technical success rates of primary and secondary endoscopic reintervention were 93.6% (44/47) and 87.5% (7/8), respectively (P = 0.47). Clinical success rates were 72.3% and 50%, respectively (P = 0.23). Stent malfunction rate after reintervention was 48.9% (23/47) and 37.5% (3/8) (P = 0.70) during follow up, and median cumulative stent patency duration was 119 and 55 days, respectively (log–rank P = 0.68). Stent patent rate after reintervention was not different according to the time interval. In univariate and multivariate analysis for stent patency duration-related factors after reintervention, there were no meaningful factors. Conclusion: Primary endoscopic reintervention for bilateral SEMS in MHO was feasible technically and clinically. However, there were no statistically meaningful factors for stent patency duration after reintervention.

Original languageEnglish
Pages (from-to)2248-2255
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume35
Issue number12
DOIs
Publication statusPublished - 2020 Dec

Bibliographical note

Funding Information:
This work was supported by the Soonchunhyang University Research Fund. Financial support:

Publisher Copyright:
© 2020 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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