The Comparison of Endoscopic Biliary Drainage in Malignant Hilar Obstruction by Cholangiocarcinoma: Bilateral Metal Stents versus Multiple Plastic Stents.

Content Provider	Europe PMC
Author	Kim, Jun Young Lee, Sang-geul Kang, Danbee Lee, Dong Kyu Park, Joo Kyung Lee, Kyu Taek Lee, Jong Kyun Lee, Kwang Hyuck
Copyright Year	2021
Abstract	Background/AimsFor the management of hilar malignant biliary obstruction (HMBO), endoscopic biliary drainage (EBD) is preferred over percutaneous transhepatic biliary drainage (PTBD) because of its convenience. However, there is no established guideline for malignant hilar obstruction that requires multiple stenting. In this study, we compared the efficacy of bilateral metal stents (BMS) versus multiple plastic stents (MPS).MethodsIn this retrospective study, we analyzed 102 patients who underwent EBD with either BMS or MPS due to HMBO caused by hilar cholangiocarcinoma between 1996 and 2018 at Samsung Medical Center. We compared the successful drainage rates, cholangitis events, overall complications, mortality, and conversion rates to PTBD between the two groups.ResultsThe successful drainage rates in the BMS group and the MPS group were 71.4% (25/35) and 65.6% (44/67), respectively, with no significant difference. The MPS group had a higher cholangitis risk (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.21 to 3.58) and higher 6-month mortality (HR, 2.91; 95% CI, 1.26 to 6.71) than the BMS group. There were no significant differences in overall complications or the conversion rate to PTBD between the groups.ConclusionsIn patients with malignant HMBO, the BMS group showed better outcomes in terms of the cholangitis rate and 6-month mortality than the MPS group. Therefore, if possible, bilateral metal stenting is recommended for HMBO caused by hilar cholangiocarcinoma.
ISSN	19762283
Journal	Gut and Liver
Volume Number	15
PubMed Central reference number	PMC8593498
Issue Number	6
PubMed reference number	34053917
e-ISSN	20051212
DOI	10.5009/gnl20257
Language	English
Publisher	Editorial Office of Gut and Liver
Publisher Date	2021-11-01
Access Restriction	Open
Rights License	This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © Gut and Liver.
Subject Keyword	Klatskin tumor Cholestasis Cholangiopancreatography, endoscopic retrograde Stents
Content Type	Text
Resource Type	Article
Subject	Hepatology Gastroenterology