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The role of stent placement above the papilla (inside-stent) as a bridging therapy for perihilar biliary malignancy: an initial experience
- Source :
- Surgery Today. 51:1795-1804
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Although endoscopic naso-biliary drainage (ENBD) is a popular preoperative biliary drainage (PBD) method for patients with perihilar biliary malignancy (PHBM), patient discomfort caused by the nasal tube remains a problem. This study aimed to analyze the safety and efficacy of PBD with the placement of a plastic stent above the papilla [inside-stent (IS)] as a bridging therapy. The outcomes of 78 patients with potentially resectable PHBM, of whom 29 underwent IS placement and 49 underwent ENBD were evaluated. The stent-associated complication rates were not different between the two groups (7% in the IS group and 10% in the ENBD group, P = 0.621). Catheter dislocation occurred less frequently (0% vs. 22%, P = 0.016), and the median time to recurrent biliary obstruction was longer (not reached vs. 32 days, P = 0.039) in the IS group than in the ENBD group. Among the patients who underwent resection, their postoperative severe complication rates were not substantially different (26% vs. 25%, P = 0.923). IS placement is a possible alternative to ENBD as a bridge to a definitive operation for patients with resectable PHBM and a prospective trial to prove its feasibility and safety is therefore warranted.
- Subjects :
- medicine.medical_specialty
Biliary drainage
business.industry
medicine.medical_treatment
Stent
General Medicine
030230 surgery
Surgery
Major duodenal papilla
Biliary malignancy
03 medical and health sciences
Stent placement
Catheter
0302 clinical medicine
030220 oncology & carcinogenesis
medicine
Complication
business
Severe complication
Subjects
Details
- ISSN :
- 14362813 and 09411291
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- Surgery Today
- Accession number :
- edsair.doi...........b3b749199de059a0bb5da00efca0b1b6