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Efficacy of Covered Metallic Stents in the Treatment of Unresectable Malignant Biliary Obstruction

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Abstract

We evaluated the efficacy of covered stents for malignant biliary obstruction. We studied 62 patients with obstruction distal to the hilar confluence who survived longer than 10 weeks and divided them into a covered stent group (group 1, n = 22), a Z stent group (group 2, n = 19), and a mesh stent group (group 3, n = 21), according to their type of the stent. Patency rates of each group were compared. Early stent revision was required after 3 days in 18% (4/22) of group 1, 26% (5/19) of group 2, and 0% (0/21) of group 3. The 10, 20, and 40-week primary patency rates were 77%, 77%, and 59% (group 1), 42%, 25%, and 8% (group 2), and 76%, 71%, and 55% (group 3), respectively. Primary patency rates of groups 1 and 3 were significantly higher than those of group 2 (p < 0.05), and there was no statistically difference between those of group 1 and group 3. The 10, 20, and 40-week assisted primary (secondary) patency rates were 96%, 96%, and 96% (group 1), 68%, 49%, and 39% (group 2), and 86%, 74%, and 58% (group 3), respectively. Assisted primary patency (secondary) rates of group 1 were significantly higher than those of groups 2 and 3 (p < 0.01 and p < 0.05, respectively). Our study suggests that the primary patency rates of the covered stents are equal to those of mesh stents, but these may be improved further if covered stents, which avoid the need for early revision, are used.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, , Fukui 918-8503, Japan

    Shiro Miyayama, Yukari Akakura, Toru Yamamoto, Hiroto Nishida, Kenji Yoneda & Keiichi Kawai

  2. Internal Medicine, Fukuiken Saiseikai Hospital, Fukui, Japan

    Daisyu Toya & Nobuyoshi Tanaka

  3. Surgery, Fukuiken Saiseikai Hospital, Fukui, Japan

    Takeshi Mitsui & Yasuyuki Asada

  4. Department of Radiology, Kanazawa University, School of Medicine, 13-1, Takara-machi, Kanazawa, 920-8640, Japan

    Osamu Matsui

Authors
  1. Shiro Miyayama
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  2. Osamu Matsui
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  3. Yukari Akakura
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  4. Toru Yamamoto
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  5. Hiroto Nishida
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  6. Kenji Yoneda
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  7. Keiichi Kawai
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  8. Daisyu Toya
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  9. Nobuyoshi Tanaka
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  10. Takeshi Mitsui
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  11. Yasuyuki Asada
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Corresponding author

Correspondence to Shiro Miyayama.

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Miyayama, S., Matsui, O., Akakura, Y. et al. Efficacy of Covered Metallic Stents in the Treatment of Unresectable Malignant Biliary Obstruction. CVIR 27, 349–354 (2004). https://doi.org/10.1007/s00270-003-2676-z

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  • DOI: https://doi.org/10.1007/s00270-003-2676-z

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