8 mm 径と 10mm 径の Fully covered Self-Expandable Metal Stents の比較試験―切除不能遠位胆管悪性狭窄患者に対する多施設共同前向き試験―

Translated title of the contribution: Comparison of 8- and 10-MM diameter fully covered selfexpandable metal stents: A multicenter prospective study in patients with distal malignant biliary obstruction

Hiroki Kawashima, Senju Hashimoto, Eizaburo Ohno, Takuya Ishikawa, Tomomasa Morishima, Hiroshi Matsubara, Hiroyuki Sugimoto, Koji Nonogaki, Akira Kanamori, Kazuo Hara, Takamichi Kuwahara, Masanao Nakamura, Ryoji Miyahara, Masatoshi Ishigami, Masahiko Ando, Yoshiki Hirooka

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The time to recurrent biliary obstruction (TRBO) of unresectable distal malignant biliary obstruction is generally thought to be longer when a self-expandable metal stent (SEMS) with a thicker inner diameter is used for drainage, but the dependence on the inner diameter using a fully covered SEMS (FCSEMS) is uncertain. The objective of this multicenter prospective study was to compare TRBO and adverse events, such as cholecystitis and pancreatitis, in treatment of patients with unresectable malignant biliary obstruction using 8- and 10- mm diameter FCSEMS. Methods: Eighteen tertiary-care centers participated in the study. Patients were allocated to the 8- and 10-mm diameter groups. TRBO, non-inferiority of the 8-mm FCSEMS, overall survival time, frequency and type of adverse events, and nonrecurrent biliary obstruction (RBO) rate at the time of death were compared between the two groups. Results: Median TRBO did not differ significantly between the 8-mm (n=102) and 10-mm (n=100) groups (275 vs 293 days, P=0.971). The hazard ratio of the 8- to 10-mm groups was 0.90 (80% confidence interval, 0.77-1.04; upper limit lower than the acceptable hazard ratio [1.33] of the null hypothesis). Based on these findings, the 8-mm diameter stent was determined to be non-inferior to the 10-mm diameter stent. Survival time, incidence of adverse events and non-RBO rate at the time of death did not differ significantly between the two groups. Conclusions: Time to RBO with an 8-mm diameter FCSEMS was non-inferior to that with a 10-mm diameter FCSEMS. This finding is important for development of future SEMS.

Translated title of the contributionComparison of 8- and 10-MM diameter fully covered selfexpandable metal stents: A multicenter prospective study in patients with distal malignant biliary obstruction
Original languageJapanese
Pages (from-to)593-603
Number of pages11
JournalGASTROENTEROLOGICAL ENDOSCOPY
Volume62
Issue number5
DOIs
Publication statusPublished - 05-2020

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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