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Primary Clinical Application of Y-Shaped Jogged Stent Implantation in Patients with Malignant Hilar Biliary Obstruction

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Objective

To assess the feasibility, safety, and efficacy of Y-shaped jogged stent in patients with malignant hilar biliary obstruction.

Methods

A total of 196 patients with malignant hilar biliary obstruction treated by biliary tract stent implantation from August 2010 to August 2017 were retrospectively reviewed. Seventeen consecutive patients who were treated with Y-shaped jogged stent implantation were identified as the Y-shaped jogged stent implantation group. Seventeen matched patients undergoing unilateral stent placement combined with percutaneous transhepatic cholangial drainage (PTCD) were enrolled as the control group. Baseline characteristics of patients, stent patency time, and survival time were compared.

Results

There was no significant difference in the age, gender, tumor type and stage, biliary obstruction classification, bilirubin level at diagnosis, presence of metastasis, or chemotherapy between the Y-stent group and the control group (P > 0.05). One week after surgery, the reduction rate of bilirubin was significantly higher in the Y-stent group (88.2% vs 53.0%, P < 0.05). The mean stent patency time was longer in the Y-stent group (7.3 ± 1.0 months vs 5.7 ± 0.9 months, P < 0.05). The mean survival time of the Y-stent group (9.1 ± 1.5 months) was longer than the control group (7.2 ± 1.1 months, P > 0.05). There was no severe complication occurred in both two groups.

Conclusion

Y-shaped jogged stent implantation was a safe, feasible, and effective approach in the treatment of patients with malignant hilar biliary obstruction, with the significantly prolonged stent patency time and survival time.

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Funding

 This work was supported by the Zhejiang Province Natural Science Funding of China (no. LQ17H180001), Zhejiang Province Medical and Health Technology Projects (no. 2017KY724, 2017KY728) and Zhejiang Province Lishui City High-level Talents Development Project (no. 2016RC29, 2017RC08 and 2017RC09), Zhejiang Province Ministry of Construction Project (no. WKJZJ-1629) and Zhejiang Province Lishui City Science and Technology Bureau Social Welfare Project (no. 2016GYX36).

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Author notes

  1. Zhongwei Zhao, Jingjing Song and Xiaoxi Fan contributed equally to this work.

Authors and Affiliations

  1. Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Lishui Central Hospital, Lishui, 323000, Zhejiang, People’s Republic of China

    Zhongwei Zhao, Jingjing Song, Xiaoxi Fan, Shiji Fang, Minjiang Chen, Weiqian Chen, Fazong Wu, Liyun Zheng, Jianfei Tu & Jiansong Ji

  2. Department of Interventional Radiology, Zhejiang University Lishui Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, No. 289 Kuocang Road, Lishui, 323000, Zhejiang, People’s Republic of China

    Zhongwei Zhao, Jingjing Song, Xiaoxi Fan, Shiji Fang, Minjiang Chen, Weiqian Chen, Fazong Wu, Liyun Zheng, Jianfei Tu & Jiansong Ji

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  1. Zhongwei Zhao
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Contributions

Zhongwei Zhao: Substantial contributions to the conception or design of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Jingjing Song: Substantial contributions to the conception or design of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Xiaoxi Fan: Substantial contributions to the conception or design of the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Shiji Fang: The acquisition, analysis, or interpretation of data for the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Minjiang Chen: The acquisition, analysis, or interpretation of data for the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Weiqian Chen: The acquisition, analysis, or interpretation of data for the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Fazong Wu: The acquisition, analysis, or interpretation of data for the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Liyun Zheng: The acquisition, analysis, or interpretation of data for the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Jianfei Tu: The acquisition, analysis, or interpretation of data for the work; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Jiansong Ji: Drafting the work or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Jiansong Ji.

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Zhao, Z., Song, J., Fan, X. et al. Primary Clinical Application of Y-Shaped Jogged Stent Implantation in Patients with Malignant Hilar Biliary Obstruction. J Gastrointest Surg 23, 745–750 (2019). https://doi.org/10.1007/s11605-019-04131-1

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