Long‐term outcomes of endoscopic double stenting using an anti‐reflux metal stent for combined malignant biliary and duodenal obstruction

• Published in: Journal of hepato-biliary-pancreatic sciences 2023-01, Vol.30 (1), p.144-152
• Main Authors: Sasaki, Takashi, Takeda, Tsuyoshi, Yamada, Yuto, Okamoto, Takeshi, Mori, Chinatsu, Mie, Takafumi, Kasuga, Akiyoshi, Matsuyama, Masato, Ozaka, Masato, Sasahira, Naoki
• Format: Article
• Language: English
• Subjects: anti‐reflux metal stent; Cholestasis - diagnostic imaging; Cholestasis - etiology; Cholestasis - surgery; combined malignant biliary and duodenal obstruction; Duodenal Obstruction - etiology; Duodenal Obstruction - surgery; endoscopic double stenting; Endoscopy; Humans; Pancreatic cancer; Self Expandable Metallic Stents - adverse effects; self‐expandable metal stent; Stents; Stents - adverse effects
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1002/jhbp.1181

Purpose To evaluate long‐term outcomes of endoscopic double stenting using anti‐reflux metal stents (ARMS) for combined malignant biliary and duodenal obstruction. Methods Consecutive patients with advanced pancreatic cancer who received endoscopic double stenting with self‐expandable metal stents (SEMS) for combined malignant biliary and duodenal obstruction at our institution between July 2014 and March 2021 were evaluated. Patients were divided into the ARMS group, endoscopic ultrasound‐guided hepaticogastrostomy (EUS‐HGS) group, and covered metal stent‐transpapillary (CMS‐transpapillary) group. A Duckbill‐type metal stent was used in all ARMS cases. Results Thirty‐eight patients were enrolled: ARMS group (n = 16), EUS‐HGS group (n = 13), and CMS‐transpapillary group (n = 9). Overall survival among three groups were not significantly different. Recurrent biliary obstruction (RBO) rates of the ARMS, EUS‐HGS, and CMS‐transpapillary groups were 12.5%, 61.5%, and 88.9% (P