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	Risk factors for early and late cholecystitis after covered metal stent placement for distal biliary obstruction.
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences
掲載区分	国内
巻・号・頁	30(10),pp.1180-1187
著者・共著者	Tatsuya Ishii,Tsuyoshi Hayashi,Hajime Yamazaki,Risa Nakamura,Kosuke Iwano,Ryo Ando,Haruka Toyonaga,Toshifumi Kin,Kuniyuki Takahashi,Akio Katanuma
発行年月	2023/10
概要	BACKGROUND: Cholecystitis is a major adverse event after self-expandable metallic stent placement for distal biliary obstruction (DBO). Covered self-expandable metallic stent (CSEMS) is being increasingly used, but few studies have investigated risk factors for cholecystitis limited to CSEMS. The present study aimed to identify risk factors for cholecystitis after CSEMS. METHODS: Patients who underwent initial CSEMS placement for DBO between November 2014 and September 2021 were enrolled and followed-up until death, recurrent biliary obstruction, cholecystitis, or until March 2022. Cholecystitis within 30 days of CSEMS was defined as early cholecystitis and after 30 days as late cholecystitis. RESULTS: Cholecystitis occurred in 51 of 339 patients (15%) after CSEMS. Forty-one patients (80.4%) had early cholecystitis, and 10 (19.6%) had late cholecystitis. Multivariate logistic regression analysis revealed that the maximum diameter of the common bile duct (CBD) (per 1 mm increase) (odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.76-1.00; p = .044), gallbladder stones (OR: 3.63; 95% CI: 1.62-8.10; p = .002), and tumor involvement in the cystic duct (CD) (OR: 4.87; 95% CI: 2.16-11.00; p < .001) were significant independent risk factors associated with early cholecystitis. No significant risk factors were identified for late cholecystitis. CONCLUSIONS: A smaller CBD diameter, gallbladder stones, and tumor involvement in the CD were identified as risk factors for early cholecystitis development after CSEMS.
DOI	10.1002/jhbp.1350
PMID	37698322