Prospective comparison of endoscopic bilateral stent-in-stent versus stent-by-stent deployment for inoperable advanced malignant hilar biliary stricture

Tae Hoon Lee, Jong Ho Moon, Jun Ho Choi, Sang Hyub Lee, Yun Nah Lee, Woo Hyun Paik, Dong Kee Jang, Byeong Wook Cho, Jae Kook Yang, Young Hwangbo, Sang Heum Park

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Background and Aims: Although the efficacy of palliative bilateral biliary drainage using self-expandable metal stents has been demonstrated, it is unclear which bilateral method is optimal for advanced malignant hilar biliary strictures (MHSs). This pilot study compared bilateral stent-in-stent (SIS) with stent-by-stent (SBS) deployment for advanced MHSs. Methods: Patients with inoperable high-grade MHSs were enrolled in this prospective randomized multicenter study. The primary outcome was the rate of adverse events, whereas secondary outcomes were technical and clinical success, reintervention, therapeutic outcomes, stent patency, and survival duration. Results: This study randomized 69 of 74 pathologically diagnosed patients to the SIS (n = 34) or SBS (n = 35) groups. The total adverse event rate after stent deployment did not differ between the 2 groups (23.5% in the SIS group vs 28.6% in the SBS group, P =.633). The primary technical success rate was 100% (34/34) and 91.4% (32/35) in the SIS and SBS groups, respectively (P =.081). The clinical success rate was 94.1% (32/34) and 90.6% (29/32), respectively (P =.668). The stent patency rate at 3 months was 85.3% in the SIS group and 65.7% in the SBS group (P =.059). At 6 months, the stent patency rate was 47.1% and 31.4%, respectively (P =.184). The median cumulative stent patency and survival probability did not differ between the 2 groups. Conclusions: Efficacy of bilateral SIS and SBS deployment may be similar in terms of total adverse events, technical and clinical success, stent patency, and survival. The stent patency rates at 3 and 6 months was higher in the SIS group without statistical difference. (Clinical trial registration number: NCT01141088.)

Original languageEnglish
Pages (from-to)222-230
Number of pages9
JournalGastrointestinal Endoscopy
Volume90
Issue number2
DOIs
StatePublished - 1 Aug 2019

Fingerprint

Stents
Pathologic Constriction
Survival

Cite this

Lee, Tae Hoon ; Moon, Jong Ho ; Choi, Jun Ho ; Lee, Sang Hyub ; Lee, Yun Nah ; Paik, Woo Hyun ; Jang, Dong Kee ; Cho, Byeong Wook ; Yang, Jae Kook ; Hwangbo, Young ; Park, Sang Heum. / Prospective comparison of endoscopic bilateral stent-in-stent versus stent-by-stent deployment for inoperable advanced malignant hilar biliary stricture. In: Gastrointestinal Endoscopy. 2019 ; Vol. 90, No. 2. pp. 222-230.
@article{45ad97782d45461f94c52a14d3995217,
title = "Prospective comparison of endoscopic bilateral stent-in-stent versus stent-by-stent deployment for inoperable advanced malignant hilar biliary stricture",
abstract = "Background and Aims: Although the efficacy of palliative bilateral biliary drainage using self-expandable metal stents has been demonstrated, it is unclear which bilateral method is optimal for advanced malignant hilar biliary strictures (MHSs). This pilot study compared bilateral stent-in-stent (SIS) with stent-by-stent (SBS) deployment for advanced MHSs. Methods: Patients with inoperable high-grade MHSs were enrolled in this prospective randomized multicenter study. The primary outcome was the rate of adverse events, whereas secondary outcomes were technical and clinical success, reintervention, therapeutic outcomes, stent patency, and survival duration. Results: This study randomized 69 of 74 pathologically diagnosed patients to the SIS (n = 34) or SBS (n = 35) groups. The total adverse event rate after stent deployment did not differ between the 2 groups (23.5{\%} in the SIS group vs 28.6{\%} in the SBS group, P =.633). The primary technical success rate was 100{\%} (34/34) and 91.4{\%} (32/35) in the SIS and SBS groups, respectively (P =.081). The clinical success rate was 94.1{\%} (32/34) and 90.6{\%} (29/32), respectively (P =.668). The stent patency rate at 3 months was 85.3{\%} in the SIS group and 65.7{\%} in the SBS group (P =.059). At 6 months, the stent patency rate was 47.1{\%} and 31.4{\%}, respectively (P =.184). The median cumulative stent patency and survival probability did not differ between the 2 groups. Conclusions: Efficacy of bilateral SIS and SBS deployment may be similar in terms of total adverse events, technical and clinical success, stent patency, and survival. The stent patency rates at 3 and 6 months was higher in the SIS group without statistical difference. (Clinical trial registration number: NCT01141088.)",
author = "Lee, {Tae Hoon} and Moon, {Jong Ho} and Choi, {Jun Ho} and Lee, {Sang Hyub} and Lee, {Yun Nah} and Paik, {Woo Hyun} and Jang, {Dong Kee} and Cho, {Byeong Wook} and Yang, {Jae Kook} and Young Hwangbo and Park, {Sang Heum}",
year = "2019",
month = "8",
day = "1",
doi = "10.1016/j.gie.2019.03.011",
language = "English",
volume = "90",
pages = "222--230",
journal = "Gastrointestinal endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "2",

}

Prospective comparison of endoscopic bilateral stent-in-stent versus stent-by-stent deployment for inoperable advanced malignant hilar biliary stricture. / Lee, Tae Hoon; Moon, Jong Ho; Choi, Jun Ho; Lee, Sang Hyub; Lee, Yun Nah; Paik, Woo Hyun; Jang, Dong Kee; Cho, Byeong Wook; Yang, Jae Kook; Hwangbo, Young; Park, Sang Heum.

In: Gastrointestinal Endoscopy, Vol. 90, No. 2, 01.08.2019, p. 222-230.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Prospective comparison of endoscopic bilateral stent-in-stent versus stent-by-stent deployment for inoperable advanced malignant hilar biliary stricture

AU - Lee, Tae Hoon

AU - Moon, Jong Ho

AU - Choi, Jun Ho

AU - Lee, Sang Hyub

AU - Lee, Yun Nah

AU - Paik, Woo Hyun

AU - Jang, Dong Kee

AU - Cho, Byeong Wook

AU - Yang, Jae Kook

AU - Hwangbo, Young

AU - Park, Sang Heum

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Background and Aims: Although the efficacy of palliative bilateral biliary drainage using self-expandable metal stents has been demonstrated, it is unclear which bilateral method is optimal for advanced malignant hilar biliary strictures (MHSs). This pilot study compared bilateral stent-in-stent (SIS) with stent-by-stent (SBS) deployment for advanced MHSs. Methods: Patients with inoperable high-grade MHSs were enrolled in this prospective randomized multicenter study. The primary outcome was the rate of adverse events, whereas secondary outcomes were technical and clinical success, reintervention, therapeutic outcomes, stent patency, and survival duration. Results: This study randomized 69 of 74 pathologically diagnosed patients to the SIS (n = 34) or SBS (n = 35) groups. The total adverse event rate after stent deployment did not differ between the 2 groups (23.5% in the SIS group vs 28.6% in the SBS group, P =.633). The primary technical success rate was 100% (34/34) and 91.4% (32/35) in the SIS and SBS groups, respectively (P =.081). The clinical success rate was 94.1% (32/34) and 90.6% (29/32), respectively (P =.668). The stent patency rate at 3 months was 85.3% in the SIS group and 65.7% in the SBS group (P =.059). At 6 months, the stent patency rate was 47.1% and 31.4%, respectively (P =.184). The median cumulative stent patency and survival probability did not differ between the 2 groups. Conclusions: Efficacy of bilateral SIS and SBS deployment may be similar in terms of total adverse events, technical and clinical success, stent patency, and survival. The stent patency rates at 3 and 6 months was higher in the SIS group without statistical difference. (Clinical trial registration number: NCT01141088.)

AB - Background and Aims: Although the efficacy of palliative bilateral biliary drainage using self-expandable metal stents has been demonstrated, it is unclear which bilateral method is optimal for advanced malignant hilar biliary strictures (MHSs). This pilot study compared bilateral stent-in-stent (SIS) with stent-by-stent (SBS) deployment for advanced MHSs. Methods: Patients with inoperable high-grade MHSs were enrolled in this prospective randomized multicenter study. The primary outcome was the rate of adverse events, whereas secondary outcomes were technical and clinical success, reintervention, therapeutic outcomes, stent patency, and survival duration. Results: This study randomized 69 of 74 pathologically diagnosed patients to the SIS (n = 34) or SBS (n = 35) groups. The total adverse event rate after stent deployment did not differ between the 2 groups (23.5% in the SIS group vs 28.6% in the SBS group, P =.633). The primary technical success rate was 100% (34/34) and 91.4% (32/35) in the SIS and SBS groups, respectively (P =.081). The clinical success rate was 94.1% (32/34) and 90.6% (29/32), respectively (P =.668). The stent patency rate at 3 months was 85.3% in the SIS group and 65.7% in the SBS group (P =.059). At 6 months, the stent patency rate was 47.1% and 31.4%, respectively (P =.184). The median cumulative stent patency and survival probability did not differ between the 2 groups. Conclusions: Efficacy of bilateral SIS and SBS deployment may be similar in terms of total adverse events, technical and clinical success, stent patency, and survival. The stent patency rates at 3 and 6 months was higher in the SIS group without statistical difference. (Clinical trial registration number: NCT01141088.)

UR - http://www.scopus.com/inward/record.url?scp=85065251094&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2019.03.011

DO - 10.1016/j.gie.2019.03.011

M3 - Article

VL - 90

SP - 222

EP - 230

JO - Gastrointestinal endoscopy

JF - Gastrointestinal endoscopy

SN - 0016-5107

IS - 2

ER -