ArticleJournal of the Chinese Medical Association : JCMA2025
Risk factors of early dysfunction after switching from plastic to metal stents in malignant extrahepatic biliary obstruction.
Article in Journal of the Chinese Medical Association : JCMA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Prediction model for the occurrence of acute pancreatitis after endoscopic retrograde cholangiopancreatography based on multidimensional indicators.World journal of gastrointestinal surgery · 2025Article
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7 authors.
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Abstract
backgroundPatients diagnosed with extrahepatic malignant biliary obstruction (MBO) often initially undergo endoscopic retrograde biliary drainage with a plastic stent (PS). Self-expandable metallic stents (SEMSs) have been shown to yield better outcomes than PS. This study aimed to identify predictors of early SEMS dysfunction in MBO patients who initially received PS and subsequently underwent SEMS placement.
methodsWe retrospectively analyzed patients who received their first SEMS insertion following prior PS placement for distal extrahepatic MBO between January 2015 and December 2021. We also analyzed the possible risk factors for early SEMS dysfunction defined as occurring within 90 days.
resultsFifty-six patients who received their first SEMS for distal extrahepatic MBO were identified. The rate of early SEMS dysfunction was 30.1%. The main causes of early SEMS dysfunction were nonspecific cholangitis (35.3%) and stent clogging (35.3%). Multivariate logistic regression analysis identified two independent predictors of early SEMS dysfunction: (a) a history of a short PS patency (<60 days), and (b) post-endoscopic retrograde cholangiopancreatography (ERCP) cholangitis following SEMS placement. The odds ratio (OR) for (a) was 10.77 (95% confidence interval [CI] 2.54 to 45.66, p = 0.001), and for (b) was (OR) 6.59 (CI 1.00-43.43, p = 0.050).
conclusionTwo risk factors associated with early SEMS dysfunction in patients with extrahepatic MBO are short PS patency (<60 days) before SEMS insertion and the development of post-ERCP cholangitis following SEMS placement.
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