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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(03): E276-E283
DOI: 10.1055/a-2039-3936
Original article

Comparison of the hybrid and partial stent-in-stent method for endoscopic three-segment drainage for unresectable malignant hilar biliary obstruction

Motohiro Yoshinari 
1   National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
2   Kumamoto University, Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto, Japan
,
Susumu Hijioka 
1   National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Yoshikuni Nagashio
1   National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Yuta Maruki
1   National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Akihiro Ohba
1   National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Yuki Kawasaki
1   National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Kotaro Takeshita
1   National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Chigusa Morizane
1   National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
,
Yasuhito Tanaka
2   Kumamoto University, Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto, Japan
,
Takuji Okusaka
1   National Cancer Center Hospital, Department of Hepatobiliary and Pancreatic Oncology, Tokyo, Japan
› Author AffiliationsSupported by: National Cancer Center Research and Development Fund 2022-A-16
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Abstract

Background and study aims The clinical outcome of the new hybrid drainage method for unresectable malignant hilar biliary obstruction (UMHBO) has not yet been compared with that of the partial stent-in-stent (PSIS) method with three or more stents.

Patients and methods Patients with UMHBO underwent drainage of three segments using the hybrid or PSIS method. The clinical outcomes of both methods were compared retrospectively.

Results Overall, 54 patients underwent the hybrid (n = 31) or PSIS (n = 23) method of drainage with three or more stents for UMHBO. There were no significant differences in the technical success rate (hybrid vs. PSIS, 87.1 % vs. 87 %), clinical success rate according to per-protocol analysis (81.5 % vs. 70 %), early adverse events rate (14.8 % vs. 10%), late adverse events rate (7.4 % vs. 0 %), and technical success rate of the endoscopic transpapillary reintervention (90.9 % vs. 100 %). Time to recurrent biliary obstruction (TRBO) of the hybrid and PSIS methods was 178 and 231 days, respectively, with no significant difference (P = 0.354).

Conclusions The choice between the two methods should be made at the physician’s discretion.

Supplementary material



Publication History

Received: 13 July 2022

Accepted after revision: 16 January 2023

Accepted Manuscript online:
21 February 2023

Article published online:
23 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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