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Koh Kitagawa,Akira Mitoro,Takahiro Ozutsumi,Masanori Furukawa,Yukihisa Fujinaga,Kenichiro Seki,Norihisa Nishimura,Yasuhiko Sawada,Kosuke Kaji,Hideto Kawaratani,Hiroaki Takaya,Kei Moriya,Tadashi Namisa 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.3
Background/Aims: Covered self-expandable metallic stents (CMSs) are widely used for malignant distal biliary obstructions (MDBOs)caused by pancreatic carcinoma. This study compared the efficacy and safety of the laser-cut-type and braided-type CMSs. Methods: To palliate MDBOs caused by pancreatic carcinoma, the laser-cut-type CMSs was used from April 2014 to March 2017, andthe braided-type CMSs was used from April 2017 to March 2019. The tested self-expandable metallic stents were equipped with differentanti-migration systems. Results: In total, 47 patients received CMSs for MDBOs (24 laser-cut type, 23 braided-type). The time to recurrent biliary obstruction(TRBO) was significantly longer in the braided-type CMSs (p=0.0008), and the median time to stent dysfunction or patient death was141 and 265 days in the laser-cut-type CMSs and braided-type CMSs, respectively (p=0.0023). Stent migration was the major cause ofstent dysfunction in both groups, which occurred in 37.5% of the laser-cut-type CMSs and 13.0% of the braided-type CMSs. Therewere no differences in the survival duration between the groups. Conclusions: The TRBO was significantly longer for the braided-type CMSs with an anti-migration system than for the laser-cut-type. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.