Stent Insertion In Patients Research Articles

Unilateral and bilateral radioactive stent insertion in patients diagnosed with inoperable hilar cholangiocarcinoma: a comparative analysis.

While hilar cholangiocarcinoma (HCCA) patients commonly undergo radioactive stent (RS) insertion treatment, the relative benefits of unilateral versus bilateral RS insertion procedures remain to be established. Accordingly, this study was designed to evaluate the relative safety and efficacy of percutaneous bilateral and unilateral RS insertion for patients with HCCA. In total, 126 HCCA patients who underwent unilateral (n=64) or bilateral (n=62) RS insertion from January 2017 - December 2021 were included in this analysis. Treatment efficacy and long-term outcomes were compared between groups. The primary endpoint was stent patency, and the secondary endpoints included technical success rate, clinical success rate, local control rate, overall survival (OS), and complications. The respective technical success rates in the unilateral and bilateral groups were 90.6% (58/64) and 93.5% (58/62) (P = 0.782). The clinical success rates were 82.8% and 86.2% in unilateral and bilateral groups, respectively (P = 0.608). Both groups exhibited comparable medial post-intervention bilirubin levels (100 vs. 99 μmol/L; P = 0.501), and restenosis occurred in 12 (20.7%) and 15 (25.9%) patients over the follow-up interval (P = 0.510). The stent reintervention rate was significantly higher in the unilateral group than bilateral group (66.7% vs. 0.0%, P < 0.001). The median stent patency in the unilateral and bilateral groups was 189 and 210 days, respectively (P = 0.796), while the median OS interval was 222 and 229 days, respectively (P = 0.969). Comparable cholangitis (17.2% vs. 22.4%, P = 0.485) and cholecystitis (3.4% vs. 3.4%, P = 1.000) rates were also detected in these two groups. In summary, HCCA patients exhibit comparable efficacy when undergoing unilateral and bilateral radioactive stenting, suggesting that unilateral RS can be routinely performed owing to the simpler nature of this procedure.

Optimising the indications for biliary stent placement during endoscopic retrograde cholangiopancreatography: a quality improvement initiative to enhance patient care and reduce healthcare resource utilisation

BackgroundA retrospective chart audit was performed to review biliary stent utilisation from January 2020 to January 2021. Non-guideline-based stent insertion was identified in 16% of patients with common bile duct...

Percutaneous Ureteral Stent Insertion in Patients with Benign Uretero-Ileal Anastomosis Strictures Who Underwent Radical Cystectomy: Assessing Risk Factors for Stent Patency.

We aimed to investigate the risk factors of early double-J ureteral stent (DJUS) dysfunction rates and the long-term patency of DJUSs inserted via a percutaneous approach in patients with benign uretero-ileal anastomosis stricture (UIAS) who had undergone radical cystectomy. In this retrospective study, 63 DJUS placements were placed via a percutaneous nephrostomy tract in 42 consecutive patients between May 2020 and March 2023. The technical success rate was 100% in all patients without major complications. The early dysfunction rate and long-term patency rate were 38.1% (24/63) and 84.2% (32/38), respectively. The blood clot retention grade, balloon dilatation, and length of the ureteral stricture exhibited a significant correlation with early DJUS dysfunction (blood clot retention grade: odds ratio (OR) 6.922 in grade two, p = 0.009; balloon dilatation: OR 0.186, p = 0.017; length of ureteral stricture: OR 8.715, p = 0.035 in moderate stenosis, and 7.646, p = 0.028 in severe stenosis). A multivariate Cox's proportional hazard analysis revealed that blood clot retention grade and length of ureteral stricture were independent predictors of long-term DJUS patency. Percutaneous insertion of the DJUSs was safe and effective in patients with benign UIAS.

Prognostic nomogram for acute pancreatitis after percutaneous biliary stent insertion in patients with malignant obstruction

ObjectiveThis study aimed to develop and validate a nomogram to predict the risk of pancreatitis after percutaneous transhepatic biliary stent insertion (PTBS) in patients with malignant biliary obstruction (MBO).Materials and methodsWe enrolled 314 patients who underwent PTBS for MBO from March 2016 to July 2021 in this retrospective study. We used univariate analysis to identify potential risk factors, while a multivariate logistic regression model was employed to establish a nomogram for predicting the risk of pancreatitis. The discrimination and calibration of the nomogram were evaluated by estimating the area under the receiver operator characteristic curve (AUC) and by bootstrap resampling and visual inspection of the calibration curve. The clinical utility of the nomogram was assessed using decision curve analysis (DCA).ResultsAfter the procedure, 41 (13.1%) patients developed pancreatitis. Based on multivariate logistic regression analysis, young age (OR = 2.57, 95% CI 1.16 to 5.69), stent insertion across the papilla (OR = 6.47, 95% CI 2.66 to 15.70), and visualization of the pancreatic duct (OR = 15.40, 95% CI 6.07 to 39.03) were associated with an elevated risk of pancreatitis. Importantly, the performance of the nomogram was satisfactory, with an identical AUC (0.807, 95% CI 0.730 to 0.883) and high-level agreement between predicted and observed probabilities as suggested in calibration curves. The DCA curve subsequently confirmed the clinical utility.ConclusionA predictive nomogram for pancreatitis after PTBS in patients with MBO was successfully established in the present study.

Efficacy of Endobiliary Radiofrequency Ablation in Preserving Survival, Performance Status and Chemotherapy Eligibility of Patients with Unresectable Distal Cholangiocarcinoma: A Case-Control Study.

Background: Cholangiocarcinoma is the most common malignancy of the bile ducts causing intrahepatic, hilar, or distal bile duct obstruction. Most jaundiced patients are diagnosed with unresectable tumors in need for palliative bile duct drainage and chemotherapy. Endobiliary radiofrequency ablation (RFA) is an adjuvant technique that may be applied prior to biliary stenting. The aim of our study was to assess the efficacy of endobiliary RFA prior to stent insertion in patients with unresectable distal cholangiocarcinomas. Methods: Twenty-five patients (eight treated with RFA and stenting and 17 treated with stenting alone) were included in a case-controlled study. We prospectively assessed the impact of RFA on the survival rate, the patient performance status, and the preservation of eligibility for chemotherapy based on the patient laboratory profile. Results: Patients treated with RFA prior to stenting proved to have a significantly longer survival interval (19 vs. 16 months, p = 0.04, 95% CI) and significantly better performance status. Moreover, the laboratory profiles of patients treated with RFA has been proven superior in terms of total bilirubin, liver enzymes, and kidney function, thus making patients likely eligible for palliative chemotherapy. Post-ERCP adverse events were scarce in both the study group and the control group. Conclusion: Given the isolated adverse events and the impact on the patient survival, performance, and laboratory profile, RFA can be considered safe and efficient in the management of patients with unresectable distal cholangiocarcinomas.

Comparison of Percutaneous Nephrostomy and Ureteral DJ Stent in Patients with Obstructive Pyelonephritis: A Retrospective Cohort Study

Purpose Comparing the two different drainage methods of percutaneous nephrostomy (PCN) versus retrograde ureteral double – J (DJ) stent insertion in patients with obstructive pyelonephritis cases. Material and methods In this retrospective study, patients with obstructive pyelonephritis secondary to urolithiasis who underwent PCN or DJ insertion were included in the study. Patients were divided into two groups according to drainage method. After exclusion criteria, the study included 105 patients. The groups were compared for intraoperative outcomes, duration of fluoroscopy usage, the time needed for normalization of infection parameters (white blood cells (WBC), C – reactive protein (CRP), procalcitonin), and complications were observed. Results From 105 patients, 56 patients were in DJ stent group and 49 patients were in PCN group. According to intraoperative data, operative time and fluoroscopy duration were significantly shorter in the DJ ureteral stent group (P < .001). WBC returned to normal range in mean 3.5 ± 1.3 days in the DJ stent group and 3.2 ± 1.1 days in the PCN group (95% CI: −0.76–0.21, P = .268). There were no statistically significant differences identified for the duration for CRP, PCT and fever to return to normal range between the drainage methods. The complication rates was 51.8% for DJ stent group and, 30.6% in PCN group (P = .028). Conclusion Both methods are effective and safe in obstructive pyelonephritis. Despite the higher complication rate in DJ stent group, these complications were minor.

Percutaneous cholecystostomy for acute cholecystitis after stent insertion in patients with malignant biliary obstruction: clinical outcomes of 107 patients.

The outcome of percutaneous cholecystostomy (PC) in malignant patients with acute cholecystitis (AC) after biliary stent insertion has not been investigated in a large group. To evaluate the clinical outcomes of PC for AC after stent insertion in patients with malignant biliary obstruction. From April 2007 to February 2019, 107 patients (57 men, 52 women; mean age = 67.5 years; age range = 27-93 years) who had undergone PC for AC after biliary stent insertion were retrospectively evaluated. Of the 107 patients, 86 underwent biliary stent insertion by the endoscopic approach and the remaining 21 patients by the percutaneous approach. All patients were classified into three groups: those with stent-induced AC; those with cancer-induced AC; and those with AC without mechanical cause (biliary stent, GB stone, or cancer invasion). The mean survival time, recurrence rate, symptom improvement, and cystic duct patency in each patient group were analyzed. Stent-induced AC (n = 40, 37.4%) developed with a mean onset time of six days (range = 0-14 days), AC without mechanical cause (n = 27, 25.2%), 87 days (range = 15-273 days), and cancer-induced AC (n = 40, 37.4%), 137 days (range = 15-447 days) after stent insertion. Symptom resolution and significant improvement in laboratory test values were achieved in 95 patients (88.8%) within four days after PC. PC is a technically safe and effective method for the treatment of AC after biliary stent insertion in patients with malignant biliary obstruction.

Study of clinical indication, difficulties and complications of DJ stenting in urological procedure at a tertiary hospital

Background: Urolithiasis is one of the major causes of morbidity in our society as our country is located near to equatorial distribution of stone disease Indwelling ureteral stents provide free drainage from the kidney to the bladder, reduce or eliminate urinary leakage and provide ureteral stenting. The present study was designed to observe indications, difficulties and complications of indwelling double J ureteral stenting. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients undergoing DJ stenting URS/ESWL (stone size &gt; 2cm), willing to participate in study. The data collected was entered into Microsoft excel and analyzed. Statistical analysis was done using descriptive statistics. Results: In the present study, we assessed prospectively the effectiveness of DJ stent insertion for treatment of ureteral stones in 100.patients. Gender distribution in the current study was 65% male and 35 % female. 65 % patients were between the age 10 to 40 years; 20 patients have lower ureteric calculi, 37 patient having mid ureteric calculi and 8 patients having upper ureteric calculi. In current study out of 100 patients 32 patients have stone between the range of 6-10 mm, 42 patients have stone size range between 11-16 mm and only 26 patient have stone size more than 16 mm. 32 patients having mid ureteric calculi in which 30 patients DJ stent procedure successfully completed, remaining 2 patients had ureteric stricture treated with URSL. 27 patients having lower ureteric calculi in which 25 patients DJ stent procedure successfully completed, remaining 2 patient had ureteric stricture treated with ESWL followed by cystoscopy removal. 8 patients having bilateral ureteric calculi in which 6 patients DJ stent procedure successfully completed, remaining 2 patient have impacted stone treated with URSL with PCNL. 100% success rate in DJ stent insertion in patients with stone size 11-16mm followed by in 93% with stone size 6-10mm and in 76% with stone size &gt;16mm. Conclusion: Most of the ureteral DJ stent related complications can be managed by surgical procedures hence they should be removed as soon as their purpose solves. The proper follow up from patients can help to early identification of post insertion complications of DJ stent and timely management of them.

Radioactive Stent Insertion for Inoperable Malignant Common Biliary Obstruction.

The purpose of this study was to assess the clinical efficacy and long-term outcomes of radioactive stent insertion in patients with malignant common biliary obstruction (MCBO). This was a retrospective study conducted at a single-center. Consecutive patients with MCBO were treated by normal or radioactive stent insertion between January 2014 and December 2019. The baseline data, instant efficacy records, and the long-term outcome results of these 2 groups were compared. During the experimental duration, at our center 71 patients with inoperable MCBO underwent normal (n=40) or radioactive (n=31) stent insertion. Rates of technical success of normal and radioactive stent insertions were both 100%. No patients exhibited procedure-related complications. All patients achieved improvements in their liver functions at 2 weeks after stent insertion. Stent dysfunction was recorded in 11 and 6 patients from the normal and radioactive stent groups, respectively (P=0.425). The median stent patency was 165 and 222 days with the normal and radioactive stents, respectively (P<0.001). All patients died due to tumor progression at the follow-up. Patients survived for a respective median of 182 and 242 days in the normal and radioactive stent groups (P<0.001). The complication rates were comparable between the 2 groups. Radioactive stent insertion may provide longer patency and overall survival in those exhibiting inoperable MCBO than normal stent insertion.

Percutaneous Biliary Metallic Stent Insertion in Patients with Malignant Duodenobiliary Obstruction: Outcomes and Factors Influencing Biliary Stent Patency.

To investigate the technical and clinical efficacy of the percutaneous insertion of a biliary metallic stent, and to identify the factors associated with biliary stent dysfunction in patients with malignant duodenobiliary obstruction. The medical records of 70 patients (39 men and 31 women; mean age, 63 years; range, 38-90 years) who were treated for malignant duodenobiliary obstruction at our institution between April 2007 and December 2018, were retrospectively reviewed. Variables found significant by univariate log-rank analysis (p < 0.2) were considered as suitable candidates for a multiple Cox's proportional hazard model. The biliary stents were successfully placed in all 70 study patients. Biliary stent insertion with subsequent duodenal stent insertion was performed in 33 patients and duodenal stent insertion with subsequent biliary stent insertion was performed in the other 37 study subjects. The median patient survival and stent patency time were 107 days (95% confidence interval [CI], 78-135 days) and 270 days (95% CI, 95-444 days), respectively. Biliary stent dysfunction was observed in 24 (34.3%) cases. Multiple Cox's proportional hazard analysis revealed that the location of the distal biliary stent was the only independent factor affecting biliary stent patency (hazard ratio, 3.771; 95% CI, 1.157-12.283). The median biliary stent patency was significantly longer in patients in whom the distal end of the biliary stent was beyond the distal end of the duodenal stent (median, 327 days; 95% CI, 249-450 days), rather than within the duodenal stent (median, 170 days; 95% CI, 115-225 days). The percutaneous insertion of the biliary metallic stent appears to be a technically feasible, safe, and effective method of treating malignant duodenobiliary obstruction. In addition, a biliary stent system with a distal end located beyond the distal end of the duodenal stent will contribute towards longer stent patency in these patients.

Role of endoscopic colonic stent insertion in patients with colonic obstructing malignancy: a single-center study

BackgroundLeft-sided colonic malignant lesions have the potential of acute bowel obstruction. Emergency surgery with stoma construction is considered the standard of management. Insertion of colonic stent to allow bowel decompression, primary resection, and re-anastomosis, avoiding the need of colostomy formation, can be an alternative. We describe our experience with the use of colonic stent in left-sided malignant obstruction as a step to relieve the obstruction before definitive surgical intervention.Patients and methodsA total of 30 patients with left-sided colonic malignant obstruction were included; 15 patients were offered colonic self-expandable metal stent insertion, and the other fifteen patients were offered emergent surgery.ResultsOf the 15 patients, 10 (66.6%) had successful stent insertion (technical and clinical). We failed to insert stent in four (26%) patients, and one (6.6%) patient had colonic perforation. All patients with successful colonic stent insertion underwent one-step resection and primary anastomosis.ConclusionColonic stent for left-sided colonic malignant obstruction represents a valuable procedure for one-step resection and primary anastomosis without the need for colostomy.

Tu1447 – Efficacy of Lumen-Apposing Metal Stent Insertion in Patients with Malignant Pancreatic Fluid Collections: A Tertiary Cancer Center Experience

Tu1447 – Efficacy of Lumen-Apposing Metal Stent Insertion in Patients with Malignant Pancreatic Fluid Collections: A Tertiary Cancer Center Experience

Predictors of Recurrent Biliary Obstruction Following Percutaneous Uncovered Metal Stent Insertion in Patients with Distal Malignant Biliary Obstruction: An Analysis Using a Competing Risk Model.

To evaluate predictive factors of recurrent biliary obstruction (RBO) following percutaneous uncovered metal stent placement for unresectable distal malignant biliary obstruction (MBO) by using a competing risk model. Between March 2012 and March 2016, 119 patients underwent percutaneous uncovered metal stent placement with distal MBO at our institution. Univariate and multivariate analyses were conducted to identify the prognostic factors for RBO using a competing risk model. The median overall survival period was 170days (range 19-775days). Recurrent biliary obstruction before death was observed in 34 patients (28.6%). The 3-, 6-, and 12-month cumulative incidences of RBO were 14.3%, 21.0%, and 27.7%, respectively. A multivariate analysis indicated that ampullary carcinoma compared with metastatic carcinoma (hazard ratio [HR] = 4.86; 95% confidence interval [CI], 1.74-13.54; P = 0.003) and a stent insertion above the sphincter of Oddi (HR 2.49; 95% CI, 1.11-5.62; P = 0.028) were the independent risk factors for RBO when we considered death to be a competing risk. Ampullary carcinoma and stent insertion above the sphincter of Oddi were risk factors for RBO in these patients who received percutaneous transhepatic stent placement.

Self-expandable metal stents in patients with postoperative delayed gastric emptying after distal gastrectomy.

AIMTo investigate the efficacy and safety of endoscopic stent insertion in patients with delayed gastric emptying after gastrectomy.METHODSIn this study, we prospectively collected data from patients who underwent stent placement for delayed gastric emptying (DGE) after distal gastrectomy between June 2010 and April 2017, at a tertiary referral academic center. Clinical improvement, complications, and consequences after stent insertion were analyzed.RESULTSTechnical success was achieved in all patients (100%). Early symptom improvement was observed in 15 of 20 patients (75%) and clinical success was achieved in all patients. Mean follow-up period was 1178.3 ± 844.1 d and median stent maintenance period was 51 d (range 6-2114 d). During the follow-up period, inserted stents were passed spontaneously per rectum without any complications in 14 of 20 patients (70%). Symptom improvement was maintained after stent placement without the requirement of any additional intervention in 19 of 20 patients (95%).CONCLUSIONEndoscopic stent placement provides prompt relief of obstructive symptoms. Thus, it can be considered an effective and safe salvage technique for post-operative DGE.

Long-Term Outcomes After Stent Insertion in Patients with Early and Late Hepatic Vein Outflow Obstruction after Living Donor Liver Transplantation

The purpose of this study was to describe the long-term effects of stent insertion in patients with hepatic venous outflow obstruction who underwent living donor liver transplantation (LDLT). Between January 2000 and December 2009, 622 adult patients underwent LDLT at our hospital. Of these patients, 21 (3.3%) were diagnosed with hepatic venous outflow obstruction (HVOO). Among these patients, stent insertion was performed in 17 patients. Then, the patients were divided into “early” and “late” groups according to when they received their HVOO diagnoses. The median follow-up period was 54.2 months (range, 0.5-192.4 months). Stent insertion was successful in 8 of 10 patients in the early group and 6 of 7 in the late group, and the 5-year primary patency rates were 46% and 20%, respectively. In both groups, patients with recurrent HVOO at the beginning had kinking confirmed by venography, and patients who had their stents for more than 3 years maintained long-term patency. Stent insertion is feasible in the long term in LDLT patients if patency is maintained. However, if kinking is seen on venography, patency maintenance is difficult. Therefore, to improve patency rate, initial surgical repair should be considered or a new indication might be needed.

Long-term outcomes after stent insertion in patients with early and late hepatic vein outflow obstruction after living donor liver transplantation.

PurposeThe purpose of this study was to describe the long-term effects of stenting in patients with hepatic venous outflow obstruction (HVOO), who underwent living donor liver transplantation (LDLT).MethodsBetween January 2000 and December 2009, 622 adult patients underwent LDLT at our hospital, and of these patients, 21 (3.3%) were diagnosed with HVOO; among these patients, 17 underwent stenting. The patients were divided into early or late groups according to the time of their HVOO diagnoses (cutoff: 60 days after liver transplantation).ResultsThe median follow-up period was 54.2 months (range, 0.5–192.4 months). Stent insertion was successful in 8 of 10 patients in the early group and 6 of 7 in the late group. The 5-year primary patency rates were 46% and 20%, respectively. In both groups, patients with recurrent HVOO at the beginning showed kinking confirmed by venography. Patients who carried their stents for more than 3 years maintained long-term patency. There was no significant difference in spleen size between groups; however, when the groups were compared according to whether they maintained patency, spleens tended to be smaller in the patency-maintained group.ConclusionUnlike stenosis, if kinking is confirmed on venography, stenting is not feasible in the long term for patients with LDLT.

Investigating Esophageal Stent-Placement Outcomes in Patients with Inoperable Non-Cervical Esophageal Cancer.

Background: Esophageal stent insertion in patients with inoperable esophageal cancer is usually accompanied with relatively high adverse symptoms and even mortality. The current study aims at investigating the outcomes of esophageal stenting in patients with inoperable non-cervical esophageal cancer.Materials and Methods: The current descriptive-analytical research evaluates 25 patients with esophageal cancer. The stent was placed in esophagus based upon endoscopy analysis with or without fluoroscopy and then the stent position and its opening was investigated by making use of CXRand Gastrografin studies. Demographic characteristics, dysphagia scores, stent placement side effects and the dysphagia-related indices were recorded and examined by taking advantage of a questionnaire which was administered pre and post stent insertion.Results: The study population was comprised of 15 women and 10 men. The individuals' average age was 69.20 ± 11.25 years. Dysphagia mean score was lowered from a value of 4.32 ± 0.80 to 2.00 ± 1.22 (P-value<0.05). The prevalent side effects were chest pain (64%), dysphagia recurrence (40%), stent blockage (20%), stent migration (16%), GI bleeding (8%), and malposition (8%). Also, it was found out that 64% of the patients survived for 6 months.Conclusion: The results indicated that although esophageal stenting is accompanied with side effects in patients with inoperable esophageal cancer, but it is the most frequently used and the most reliable method in relieving dysphagia and improving dysphagia-related life indices.

Unilateral versus bilateral stent insertion for malignant hilar biliary obstruction.

To determine the clinical efficiency and long-term outcomes between unilateral and bilateral stent insertion in patients with malignant hilar biliary obstruction. From August 2012 to February 2016, 63 consecutive patients with malignant hilar biliary obstruction were treated with unilateral or bilateral stent insertion at our center. The bilateral stents were inserted using the side-by-side technique. The clinical efficiency and long-term outcomes were compared between the two groups. Unilateral and bilateral stent insertions were successfully performed in 31 of 33 and 27 of 30 patients, respectively (P=0.912). No procedure-related complication occurred. Clinical success was achieved in 29 of 31 patients in the unilateral stent group and in 26 of 27 patients in the bilateral stent group (P=0.637). During the follow-up, re-obstruction of stent occurred in five patients in the unilateral stent group and in three patients in the bilateral stent group (P=0.58). The significant differences were not observed in the stent patency time (368 vs. 387days, P=0.685) and survival (200 vs. 198days, P=0.751) between two groups. Based on the univariate and multivariate analyses, the independent risk factors for decreasing the survival time included higher Eastern Cooperative Oncology Group performance status (P=0.018), higher alanine aminotransferase level (P=0.009), and absence of anticancer treatment after stent insertion (P=0.002). Compared to bilateral stent insertion for malignant hilar biliary obstruction, unilateral stent insertion can provide comparable clinical efficiency and long-term outcomes.

Risk Factors for Non-occlusion Cholangitis After Metal Stent Insertion in Patients with Malignant Distal Biliary Obstruction

Introduction: After self-expanding metal stents (SEMS) insertion for malignant biliary obstruction, occlusion cholangitis by tumor ingrowth or overgrowth is one of major problems, which leads to the delay of chemotherapy or SEMS dysfunction. However, acute cholangitis without stent occlusion also develops clinically. Pathophysiology and prognosis in patients with non-occlusion cholangitis remains unclear. The aim of this study is to evaluate the risk factors for non-occlusion cholangitis and its impact on prognosis. Methods: From April 2011 to April 2016, SEMS were inserted for the first time in 74 patients with malignant distal biliary obstruction at Kitano Hospital. Non-occlusion cholangitis was diagnosed when CT and/or endoscopic retrograde cholangiopancreatography revealed no stent occlusion in patients with fever and abnormal liver function tests. Incidence rate of non-occlusion cholangitis after SEMS insertion was evaluated based on Kaplan-Meier method, the prognoses in incidence and non-incidence groups were compared, and the different characteristics of patients between both groups were analyzed using cox regression analysis. Results: Among 74 patients who received SEMS insertion, non-occlusion cholangitis was observed in 31 patients (41.9%). The median duration between SEMS insertion and the onset of non-occlusion cholangitis was 141 days. Cumulative incidence rate at 100 and 365 days after SEMS insertion were 30.0% and 66.3%, respectively. With the passage of time after SEMS insertion, cumulative survival rate of incidence group was lower than non-incidence group, although there was no significant difference (P= 0.63) (Figure 1). In the multivariate analysis, significant risk factors for non-occlusion cholangitis were pancreatic cancer (hazard ratio [HR] 4.83, P= 0.007) and duodenal invasion (hazard ratio [HR] 2.45, P= 0.04).Figure 1Conclusion: Our data suggests that non-occlusion cholangitis occurs frequently and can impact on longterm prognosis of cancer patients. When pancreatic cancer invades duodenum, duodenal hypoperistalsis easily induces duodenobiliary reflux through SEMS. Therefore, biliary drainage preserving Oddi sphincter function, such as percutaneous and endoscopic ultrasound-guided approaches, might be better to improve long-term prognosis in patients with pancreatic cancer accompanied with duodenal invasion. In conclusion, duodenobiliary reflux by duodenoal invasion of pancreastic cancer would be major cause of non-occlusion cholangitis.

Complications of prophylactic pancreatic stent insertion in patients with increased risk of post-ERCP Pancreatitis

Complications of prophylactic pancreatic stent insertion in patients with increased risk of post-ERCP Pancreatitis