Features of malignant biliary obstruction affecting the patency of metallic stents

A multicenter study

Hyunsoo Kim, DongKi Lee, Ho Gak Kim, Jong Jae Park, Sang Heum Park, Jin Hong Kim, Byung Moo Yoo, Im Hwan Roe, Young Soo Moon, Seung Jae Myung

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Background: Although placement of a metallic stent is an established therapeutic option for the palliation of patients with malignant biliary obstruction, it remains unclear which stricture-related or stent-related factors influence stent patency. Methods: Metallic stents were inserted endoscopically in 68 patients (38 men, 30 women; mean age 70.2 ± 8.5 years) with malignant biliary obstruction. Patency rates were prospectively analyzed according to malignant stricture characteristics, including length, morphologic type, and degree of narrowing. Furthermore, patient age, initial serum bilirubin level, length of stent, time to adequate expansion, and the location of the distal end of the stent were evaluated as possible factors affecting the stent patency. Stent patency was assessed by using the survival analysis of the Kaplan-Meier estimation and Cox regression analysis. Results: Median overall stent patency was 231 days (range 27-379 days) and the overall rate of stent occlusion 41.2% (28/68). The causes of occlusion were tumor ingrowth in 23 patients (33.8%), distal overgrowth in 3 (4.4%), proximal overgrowth in 1 (1.5%), and encrustation with sludge in 1 patient (1.5%). No significant differences in patency rates according to patient age, initial serum bilirubin level, primary tumor type, length and morphologic type of stricture, and length and location of the distal end of the stent were found. Cox regression analysis demonstrated that the degree of narrowing assessed by cannula or guidewire passage and the time to adequate expansion of the stent were independent factors associated with stent patency. Conclusion: Early expansion of the stent and easy passage of larger-caliber instruments through the stricture were favorable factors for long-term patency of the Wallstent.

Original languageEnglish
Pages (from-to)359-365
Number of pages7
JournalGastrointestinal Endoscopy
Volume55
Issue number3
DOIs
Publication statusPublished - 2002 Jan 1

Fingerprint

Multicenter Studies
Stents
Pathologic Constriction
Bilirubin
Regression Analysis
Survival Analysis
Sewage
Serum
Neoplasms

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Kim, Hyunsoo ; Lee, DongKi ; Kim, Ho Gak ; Park, Jong Jae ; Park, Sang Heum ; Kim, Jin Hong ; Yoo, Byung Moo ; Roe, Im Hwan ; Moon, Young Soo ; Myung, Seung Jae. / Features of malignant biliary obstruction affecting the patency of metallic stents : A multicenter study. In: Gastrointestinal Endoscopy. 2002 ; Vol. 55, No. 3. pp. 359-365.
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abstract = "Background: Although placement of a metallic stent is an established therapeutic option for the palliation of patients with malignant biliary obstruction, it remains unclear which stricture-related or stent-related factors influence stent patency. Methods: Metallic stents were inserted endoscopically in 68 patients (38 men, 30 women; mean age 70.2 ± 8.5 years) with malignant biliary obstruction. Patency rates were prospectively analyzed according to malignant stricture characteristics, including length, morphologic type, and degree of narrowing. Furthermore, patient age, initial serum bilirubin level, length of stent, time to adequate expansion, and the location of the distal end of the stent were evaluated as possible factors affecting the stent patency. Stent patency was assessed by using the survival analysis of the Kaplan-Meier estimation and Cox regression analysis. Results: Median overall stent patency was 231 days (range 27-379 days) and the overall rate of stent occlusion 41.2{\%} (28/68). The causes of occlusion were tumor ingrowth in 23 patients (33.8{\%}), distal overgrowth in 3 (4.4{\%}), proximal overgrowth in 1 (1.5{\%}), and encrustation with sludge in 1 patient (1.5{\%}). No significant differences in patency rates according to patient age, initial serum bilirubin level, primary tumor type, length and morphologic type of stricture, and length and location of the distal end of the stent were found. Cox regression analysis demonstrated that the degree of narrowing assessed by cannula or guidewire passage and the time to adequate expansion of the stent were independent factors associated with stent patency. Conclusion: Early expansion of the stent and easy passage of larger-caliber instruments through the stricture were favorable factors for long-term patency of the Wallstent.",
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Features of malignant biliary obstruction affecting the patency of metallic stents : A multicenter study. / Kim, Hyunsoo; Lee, DongKi; Kim, Ho Gak; Park, Jong Jae; Park, Sang Heum; Kim, Jin Hong; Yoo, Byung Moo; Roe, Im Hwan; Moon, Young Soo; Myung, Seung Jae.

In: Gastrointestinal Endoscopy, Vol. 55, No. 3, 01.01.2002, p. 359-365.

Research output: Contribution to journalArticle

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T1 - Features of malignant biliary obstruction affecting the patency of metallic stents

T2 - A multicenter study

AU - Kim, Hyunsoo

AU - Lee, DongKi

AU - Kim, Ho Gak

AU - Park, Jong Jae

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AU - Kim, Jin Hong

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AU - Roe, Im Hwan

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AU - Myung, Seung Jae

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N2 - Background: Although placement of a metallic stent is an established therapeutic option for the palliation of patients with malignant biliary obstruction, it remains unclear which stricture-related or stent-related factors influence stent patency. Methods: Metallic stents were inserted endoscopically in 68 patients (38 men, 30 women; mean age 70.2 ± 8.5 years) with malignant biliary obstruction. Patency rates were prospectively analyzed according to malignant stricture characteristics, including length, morphologic type, and degree of narrowing. Furthermore, patient age, initial serum bilirubin level, length of stent, time to adequate expansion, and the location of the distal end of the stent were evaluated as possible factors affecting the stent patency. Stent patency was assessed by using the survival analysis of the Kaplan-Meier estimation and Cox regression analysis. Results: Median overall stent patency was 231 days (range 27-379 days) and the overall rate of stent occlusion 41.2% (28/68). The causes of occlusion were tumor ingrowth in 23 patients (33.8%), distal overgrowth in 3 (4.4%), proximal overgrowth in 1 (1.5%), and encrustation with sludge in 1 patient (1.5%). No significant differences in patency rates according to patient age, initial serum bilirubin level, primary tumor type, length and morphologic type of stricture, and length and location of the distal end of the stent were found. Cox regression analysis demonstrated that the degree of narrowing assessed by cannula or guidewire passage and the time to adequate expansion of the stent were independent factors associated with stent patency. Conclusion: Early expansion of the stent and easy passage of larger-caliber instruments through the stricture were favorable factors for long-term patency of the Wallstent.

AB - Background: Although placement of a metallic stent is an established therapeutic option for the palliation of patients with malignant biliary obstruction, it remains unclear which stricture-related or stent-related factors influence stent patency. Methods: Metallic stents were inserted endoscopically in 68 patients (38 men, 30 women; mean age 70.2 ± 8.5 years) with malignant biliary obstruction. Patency rates were prospectively analyzed according to malignant stricture characteristics, including length, morphologic type, and degree of narrowing. Furthermore, patient age, initial serum bilirubin level, length of stent, time to adequate expansion, and the location of the distal end of the stent were evaluated as possible factors affecting the stent patency. Stent patency was assessed by using the survival analysis of the Kaplan-Meier estimation and Cox regression analysis. Results: Median overall stent patency was 231 days (range 27-379 days) and the overall rate of stent occlusion 41.2% (28/68). The causes of occlusion were tumor ingrowth in 23 patients (33.8%), distal overgrowth in 3 (4.4%), proximal overgrowth in 1 (1.5%), and encrustation with sludge in 1 patient (1.5%). No significant differences in patency rates according to patient age, initial serum bilirubin level, primary tumor type, length and morphologic type of stricture, and length and location of the distal end of the stent were found. Cox regression analysis demonstrated that the degree of narrowing assessed by cannula or guidewire passage and the time to adequate expansion of the stent were independent factors associated with stent patency. Conclusion: Early expansion of the stent and easy passage of larger-caliber instruments through the stricture were favorable factors for long-term patency of the Wallstent.

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