Clinical effect of different plastic biliary stent indwelling methods on managing obstructive jaundice in unresectable hilar cholangiocarcinoma
Wang Jian, Chu Jiangtao, Zhang Yueming, Dou Lizhou, Liu Yong, Ke Yan, Liu Xudong, Liu Yumeng, Wang Guiqi, He Shun
Abstract
ObjectiveTo compare the clinical effect of three indwelling methods of plastic biliary stent on relieving obstructive jaundice caused by unresectable hilar cholangiocarcinoma.
MethodsA retrospective study was performed on data of 61 patients with obstructive jaundice caused by unresectable hilar cholangiocarcinoma from April 2014 to December 2020 in Cancer Hospital, Chinese Academy of Medical Sciences. Plastic biliary stent placement was used to relieve jaundice, including 18 cases of intragastric indwelling at the end of biliary stent, 31 cases of duodenal papilla indwelling at the end of biliary stent, and 12 cases of horizontal portion of duodenum indwelling at the end of biliary stent. Incidence of fever within 2 weeks, perioperative mortality, 90-day obstruction rate, and median stent patency period were followed up and the results were analyzed.
ResultsThe incidence of fever within 2 weeks of the three groups were significantly different [66.7% (12/18), 58.1% (18/31) and 16.7% (2/12), χ2=7.30, P=0.026]. There were no statistically differences in the perioperative mortality [0 (0/16), 3.2% (1/31) and 0 (0/10), χ2=1.09, P=1.000], 90-day obstruction rate [52.9% (9/17), 48.3% (14/29) and 40.0% (4/10), χ2=1.91, P=0.589], or median stent patency period (66.0 d, 91.5 d and 94.0 d, Z=4.96, P=0.084) among three groups.
ConclusionPatients with biliary plastic stents with ends placed at the horizontal portion of the duodenum show lower incidence of fever within two weeks after implantation, and similar median stent patency period, 90-day obstruction rate and perioperative mortality compared with intragastric indwelling and duodenal papilla indwelling groups. Therefore, biliary plastic stents with ends placed at the horizontal portion of the duodenum should be recommended as the preferred procedure.
Key words:
Jaundice, obstructive; Unresectable hilar cholangiocarcinoma; Plastic stent placement
Contributor Information
Wang Jian
Department of Colorectal Oncology Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
National Cancer Center
National Clinical Research Center for Cancer
Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Chu Jiangtao
National Cancer Center
National Clinical Research Center for Cancer
Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Zhang Yueming
National Cancer Center
National Clinical Research Center for Cancer
Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Dou Lizhou
National Cancer Center
National Clinical Research Center for Cancer
Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Liu Yong
National Cancer Center
National Clinical Research Center for Cancer
Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Ke Yan
National Cancer Center
National Clinical Research Center for Cancer
Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Liu Xudong
National Cancer Center
National Clinical Research Center for Cancer
Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Liu Yumeng
National Cancer Center
National Clinical Research Center for Cancer
Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Wang Guiqi
National Cancer Center
National Clinical Research Center for Cancer
Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
He Shun
National Cancer Center
National Clinical Research Center for Cancer
Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
