論文種別	原著(症例報告除く)
言語種別	英語
査読の有無	その他(不明)
表題	Re-intervention with 10-mm vs 12-mm covered self-expandable metallic stent for recurrent unresectable distal biliary obstruction in patients with previous stent implantation.
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences
掲載区分	国内
巻・号・頁	30(4),pp.542-549
著者・共著者	Koki Chikugo,Tsuyoshi Hayashi,Kazunari Tanaka,Toshifumi Kin,Haruka Toyonaga,Osamu Nasuno,Tatsuya Ishii,Kuniyuki Takahashi,Hajime Yamazaki,Akio Katanuma
発行年月	2023/04
概要	BACKGROUND: Treatment for unresectable distal malignant biliary obstruction (DMBO) involves placing a 10-mm covered self-expandable metallic stent (CSEMS). In recurrent biliary obstruction (RBO), replacement of the CSEMS is recommended; however, the appropriate stent type remains unknown. We speculated that large-bore CSEMSs would provide longer patency. We compared the efficacy of 10-mm and 12-mm CSEMS in patients with RBO. METHODS: We retrospectively retrieved data on patients who underwent CSEMS replacement from the endoscopic database. We investigated the time to RBO (TRBO) after CSEMS replacement. The hazard ratio (HR) for the the second TRBO was estimated using the Cox proportional hazard model. The estimated median second TRBO was determined using the Kaplan-Meier method. RESULTS: Among the 493 patients with DMBOs treated with 10-mm CSEMS, 48 and 29 patients underwent re-intervention with 10-mm and 12-mm CSEMS, respectively. The use of 12-mm CSEMS was inversely associated with second TRBO (multivariable-adjusted HR, 0.62; 95% CI, 0.39-0.98; P = .042). The estimated median second TRBO was greater with the 12 mm CSEMS than with the 10 mm variety (562 days vs 207 days; P = .019). CONCLUSION: The second intervention with 12-mm CSEMS was associated with a longer TRBO.
DOI	10.1002/jhbp.1243
PMID	36179153