1
|
Fritzsche JA, de Jong DM, Borremans JJMM, Bruno MJ, Van Delden OM, Erdmann JI, Fockens P, de Gooyer PGM, Groot Koerkamp B, Klümpen HJ, Moelker A, Montazeri NSM, Nooijen LE, Ponsioen CY, Van Wanrooij RLJ, van Driel LMJW, Voermans RP. Long-term efficacy of metal versus plastic stents in inoperable perihilar cholangiocarcinoma; a multicenter retrospective propensity score matched comparison. HPB (Oxford) 2023:S1365-182X(23)00097-7. [PMID: 37059650 DOI: 10.1016/j.hpb.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/06/2023] [Accepted: 03/19/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND For palliative drainage of inoperable perihilar cholangiocarcinoma (pCCA) uncovered metal stents are preferred over plastic stents. However, there is a lack of data on re-interventions at the long-term. The aim is to evaluate the potential difference in the number of re-interventions in patients surviving at least 6 months. METHODS Retrospective study including patients with pCCA who underwent plastic stent placement(s) or had metal stent(s) in situ for at least 6 months. The primary outcome was the number of re-interventions per patient-year. A propensity score matching (1:1) analysis was performed using age, Bismuth classification, reason for inoperability, pathological confirmation, systemic therapy and initial approach (endoscopic vs percutaneous). RESULTS Patients in the metal stent group (n = 87) underwent fewer re-interventions compared with the plastic stent group (n = 40) (3.0 vs. 4.7 per patient-year; IRR, 0.64; 95% CI, 0.47 to 0.88). When only non-elective re-interventions were included, there was no significant difference (2.1 vs. 2.7; IRR, 0.76; 95% CI, 0.55 to 1.08). Results were similar in the propensity score-matched dataset. CONCLUSIONS This study shows that, also in patients with inoperable pCCA who survive at least 6 months, placement of metal stent(s) leads to fewer re-interventions in comparison with plastic stents.
Collapse
Affiliation(s)
- Jeska A Fritzsche
- Amsterdam UMC, Location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands.
| | - David M de Jong
- Erasmus University Medical Center, Erasmus MC Cancer Center, Department of Gastroenterology and Hepatology, Rotterdam, the Netherlands
| | - Jasmijn J M M Borremans
- Amsterdam UMC, Location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands
| | - Marco J Bruno
- Erasmus University Medical Center, Erasmus MC Cancer Center, Department of Gastroenterology and Hepatology, Rotterdam, the Netherlands
| | - Otto M Van Delden
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC, Location University of Amsterdam, Department of Interventional Radiology, Amsterdam, the Netherlands
| | - Joris I Erdmann
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands
| | - Paul Fockens
- Amsterdam UMC, Location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC, Location Vrije Universiteit, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands
| | - Peter G M de Gooyer
- Amsterdam UMC, Location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands
| | - Bas Groot Koerkamp
- Erasmus University Medical Center, Erasmus MC Cancer Center, Department of Surgery, Rotterdam, the Netherlands
| | - Heinz-Josef Klümpen
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC, Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands
| | - Adriaan Moelker
- Erasmus University Medical Center, Erasmus MC Cancer Center, Department of Radiology and Nuclear Medicine, Rotterdam, the Netherlands
| | - Nahid S M Montazeri
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands; Amsterdam UMC, Location University of Amsterdam, Biostatistics Unit, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands
| | - Lynn E Nooijen
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC, Location Vrije Universiteit, Department of Surgery, Amsterdam, the Netherlands
| | - Cyriel Y Ponsioen
- Amsterdam UMC, Location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
| | - Roy L J Van Wanrooij
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Amsterdam UMC, Location Vrije Universiteit, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands
| | - Lydi M J W van Driel
- Erasmus University Medical Center, Erasmus MC Cancer Center, Department of Gastroenterology and Hepatology, Rotterdam, the Netherlands
| | - Rogier P Voermans
- Amsterdam UMC, Location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands.
| |
Collapse
|
2
|
Ueno S, Ogura T, Kawai J, Yamamura M, Higuchi K. Across-the-papilla side-by-side deployment of three braided stents for malignant hilar biliary obstruction. Endoscopy 2022; 54:E594-E595. [PMID: 34933372 DOI: 10.1055/a-1711-3793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Saori Ueno
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Takeshi Ogura
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Jyunichi Kawai
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Masahiro Yamamura
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| |
Collapse
|