Document Detail

Unilateral versus bilateral endoscopic metal stenting for malignant hilar biliary obstruction.
MedLine Citation:
PMID:  19220678     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIM: The extent of liver drainage for palliative treatment of malignant hilar biliary obstruction is controversial. The aim of this study was to compare endoscopic unilateral versus bilateral drainage in patients with malignant hilar biliary obstruction using a self-expanding metal stent (SEMS). METHODS: We carried out a retrospective review of 46 consecutive patients with malignant hilar biliary obstruction who were treated by endoscopic biliary drainage using SEMS between 1997 and 2005. Unilateral metal stenting (group A) was performed in 17 patients between 1997 and 2000, and bilateral metal stenting (group B) was performed in 29 patients between 2001 and 2005. The successful stent insertion, successful drainage, early complications, late complications, stent patency, and survival rate for groups A and B were evaluated and compared retrospectively. RESULTS: There were no significant differences between the two groups in successful stent insertion (100% vs 90%, group A vs B, respectively), successful drainage (100% vs 96%), early complications (0% vs 10%), or late complications (65% vs 54%). Cumulative stent patency was significantly better in group B than in group A (P = 0.009). In cases of cholangiocarcinoma, cumulative stent patency was significantly better in group B than in group A (P = 0.009), whereas there were no inter-group differences for gallbladder carcinoma. Cumulative survival did not differ significantly between the groups. CONCLUSIONS: Endoscopic bilateral drainage using SEMS for malignant hilar biliary obstruction is more effective than unilateral drainage in terms of cumulative stent patency, especially in cases of cholangiocarcinoma.
Itaru Naitoh; Hirotaka Ohara; Takahiro Nakazawa; Tomoaki Ando; Kazuki Hayashi; Fumihiro Okumura; Yasutaka Okayama; Hitoshi Sano; Yasuhiro Kitajima; Masaaki Hirai; Tessin Ban; Katsuyuki Miyabe; Koichiro Ueno; Hiroaki Yamashita; Takashi Joh
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-02-12
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  24     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-16     Completed Date:  2009-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  552-7     Citation Subset:  IM    
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
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MeSH Terms
Aged, 80 and over
Balloon Dilatation
Biliary Tract Neoplasms / complications,  mortality,  radiography,  surgery*
Cholestasis / etiology,  mortality,  radiography,  surgery*
Drainage / adverse effects,  instrumentation,  methods*
Endoscopy, Gastrointestinal* / adverse effects
Kaplan-Meiers Estimate
Middle Aged
Palliative Care
Prosthesis Design
Retrospective Studies
Treatment Outcome
Reg. No./Substance:

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