Comparative study of stent placement and drainage tube placement for malignant bilioenteric anastomotic stricture

doi:10.3877/cma.j.issn.2095-5782.2020.02.012

Abstract

Abstract:

Objective

To compare efficacy and safety of self-expandable metallic stent (SEMS) placement and catheter drainage for malignant bilioenteric anastomotic stricture (BAS).

Methods

This study included 33 patients with malignant BAS treated from March 2016 to June 2019. Nineteen patients underwent insertion of SEMS (Stent group); the remaining fourteen patients underwent catheter drainage (Catheter group). Technical success was defined as successful placement of stent or drainage catheter in the appropriate position; clinical success was defined as 20% reduction in serum bilirubin within 1 week after the procedure, compared with baseline. Complications, duration to stent/catheter malfunction, and overall survival were evaluated.

Results

Technical success was achieved in all patients in both groups. In the Stent group, 15 patients received one stent and the other 4 patients required two stents. Clinical success rates were similar between the groups [Stent group, 94.7% (18/19); Catheter group, 92.9% (13/14)]. There were no major complications. The median duration to stent/catheter malfunction was significantly longer in the Stent group (130 days) than that in the control group (61 days; P=0.001). The median overall survival was also significantly longer in the Stent group (159 days) than that in the Control group (65 days; P=0.003).

Conclusions

SEMS placement may be better than drainage catheter insertion for malignant BAS in terms of the duration before stent/catheter malfunction and patient survival.

Key words: Malignant bilioenteric anastomotic stricture, Self-expandable metallic stent, Catheter drainage, Stent patency, Survival

Wei Wan, Weizhong Zhou, Sheng Liu, Haibin Shi. Comparative study of stent placement and drainage tube placement for malignant bilioenteric anastomotic stricture[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2020, 08(02): 160-165.

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URL: https://zhjrfsxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-5782.2020.02.012

https://zhjrfsxdzzz.cma-cmc.com.cn/EN/Y2020/V08/I02/160

Figures/Tables 7

References 11

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?		引流管组	支架组	P值
病例数		14	19	?
年龄		63.07（51~73）	61（43~82）	0.534
性别（男/女）		11/3	11/8	0.213
原发肿瘤		?	?	0.528
?	胆管癌	9	13	?
?	胰腺癌	3	2	?
?	胆囊癌	2	2	?
?	胃癌	0	2	?
ECOG		?	?	0.403
?	1	12	14	?
?	2	2	5	?
CA199>1 000		8	8	0.393
后续化疗		2	4	0.618

?		引流管组	支架组	P值
病例数		14	19	?
年龄		63.07（51~73）	61（43~82）	0.534
性别（男/女）		11/3	11/8	0.213
原发肿瘤		?	?	0.528
?	胆管癌	9	13	?
?	胰腺癌	3	2	?
?	胆囊癌	2	2	?
?	胃癌	0	2	?
ECOG		?	?	0.403
?	1	12	14	?
?	2	2	5	?
CA199>1 000		8	8	0.393
后续化疗		2	4	0.618

?		引流管组	支架组	P值
ALT		?	?	?
?	治疗前	95.98±110.02	71.53±62.12	0.437
?	治疗后	49.23±25.52	53.54±36.59	0.772
?	P值	0.129	0.012	?
AST		?	?	?
?	治疗前	122.04±92.75	88.47±60.92	0.233
?	治疗后	57.84±31.32	55.49±21.78	0.859
?	P值	0.071	0.008	?
TBIL		?	?	?
?	治疗前	243.22±106.81	204.87±148.70	0.452
?	治疗后	142.35±49.83	117.7±96.52	0.492
?	P值	0.002	<0.001	?
DBIL		?	?	?
?	治疗前	168.20±76.74	155.82±112.36	0.744
?	治疗后	104.23±32.67	88.14±62.40	0.514
?	P值	0.005	0.004	?

?		引流管组	支架组	P值
ALT		?	?	?
?	治疗前	95.98±110.02	71.53±62.12	0.437
?	治疗后	49.23±25.52	53.54±36.59	0.772
?	P值	0.129	0.012	?
AST		?	?	?
?	治疗前	122.04±92.75	88.47±60.92	0.233
?	治疗后	57.84±31.32	55.49±21.78	0.859
?	P值	0.071	0.008	?
TBIL		?	?	?
?	治疗前	243.22±106.81	204.87±148.70	0.452
?	治疗后	142.35±49.83	117.7±96.52	0.492
?	P值	0.002	<0.001	?
DBIL		?	?	?
?	治疗前	168.20±76.74	155.82±112.36	0.744
?	治疗后	104.23±32.67	88.14±62.40	0.514
?	P值	0.005	0.004	?

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