| 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 | Long-Term Outcomes of Plastic Versus Metal Stents for Preoperative Biliary Drainage in Pancreatic Cancer: A Nationwide Propensity Score-Matched Analysis. |
| 掲載誌名 | 正式名：Gastrointestinal endoscopy 略 称：Gastrointest Endosc ISSNコード：10976779/00165107 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Kazumasa Nagai, Shinya Hirakawa, Masamichi Mizuma, Hisateru Tachimori, Takao Itoi, Shinichi Egawa, Manabu Kawai, Yuzo Kodama, Sohei Satoi, Kohei Nakata, Shin Hamada, Ichiro Yasuda, Michiaki Unno, Yoshihiro Kakeji, Ken Shirabe, Kazuichi Okazaki, Yoshifumi Takeyama, Atsushi Masamune |
| 発行年月 | 2026/06 |
| 概要 | BACKGROUNDS AND AIMS:Preoperative biliary drainage (PBD) is frequently required in patients with pancreatic ductal adenocarcinoma (PDAC) undergoing curative intent surgery presenting with obstructive jaundice. With the increasing use of neoadjuvant therapy (NAT), optimal stent selection-plastic stents (PS) versus metal stents (MS)-remains controversial, particularly regarding long-term outcomes. Here, using the National Clinical Database (NCD), we compared overall survival (OS) and recurrence-free survival (RFS) between MS and PS in patients undergoing ERCP before pancreaticoduodenectomy (PD) for PDAC.METHODS:We performed a nationwide propensity score-matched cohort study of patients with PDAC who underwent PD after PBD between 2012 and 2017. Patients who underwent ERCP were categorized into two groups: PS and MS. The primary endpoint was OS; secondary endpoints included RFS and surgical outcomes. Secondary analyses included a NAT subgroup and comparison of ERCP with PTBD.RESULTS:Among 6,429 eligible patients, 5,621 underwent ERCP (PS: n=3225; MS: n=451; endoscopic nasobiliary drainage: n=1823; excluded cases: n=122) and 808 underwent PTBD. After matching, with a median follow-up period of 63.1 months (IQR, 38.9-77.6), OS and RFS demonstrated no significant differences between PS and MS, both in the overall ERCP cohort and the NAT subgroup. Postoperative adverse events did not differ significantly between the groups. Secondary analysis showed no survival differences between ERCP and PTBD.CONCLUSIONS:In this nationwide real-world propensity score-matched study, no significant differences were observed between PS and MS in long-term oncologic and surgical outcomes after PD for PDAC, including among patients who received NAT. Stent choice should be individualized based on drainage duration and treatment strategy, rather than expectations of long-term prognosis. |
| DOI | 10.1016/j.gie.2026.05.032 |
| PMID | 42248481 |