Journal article
Unilateral versus bilateral hilar stents for the treatment of cholangiocarcinoma: a multicenter international study
Annals of gastroenterology, v 33(2), pp 202-209
01 Jan 2020
PMID: 32127742
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
Endoscopic placement of hilar stents is an accepted palliative therapy for patients with advanced, unresectable cholangiocarcinoma. However, whether unilateral versus bilateral stent placement provides optimal relief continues to be a subject of debate. The aim of this study was to compare the technical and clinical outcomes in patients with inoperable cholangiocarcinoma who received unilateral or bilateral self-expanding metal stents (SEMS).
Methods
We conducted a multicenter, international retrospective study of 187 patients with cholangiocarcinoma who received unilateral or bilateral SEMS. Outcomes included, but were not limited to, technical success, clinical success, adverse events, stent occlusion, and survival time. Results were further stratified based on the Bismuth classification.
Results
Fifty patients received unilateral stents and 137 patients received bilateral stents. All patients achieved technical success. The clinical success rates were 86% for unilateral stents and 82.5% for bilateral stents (P>0.99). Clinical success was not statistically different for either group when stratified by the Bismuth classification (P=0.62 and P=0.72 respectively). There were significantly more adverse events in the bilateral stents group (11.7% vs. 0%, P=0.007). There was no greater risk of stent occlusion when bilateral stents were used (unadjusted P=0.71, adjusted P=0.81). There was a greater risk of death for patients who received bilateral SEMS (hazard ratio 1.78, 95% confidence interval 1.09-2.89; P=0.02).
Conclusions
Unilateral and bilateral drainage had similar technical and clinical success rates. However, bilateral stents had a higher risk of death and more adverse events. Therefore, unilateral SEMS placement is sufficient for relief of biliary obstruction secondary to cholangiocarcinoma.
Metrics
Details
- Title
- Unilateral versus bilateral hilar stents for the treatment of cholangiocarcinoma: a multicenter international study
- Creators
- Judith Staub - University of UtahAli Siddiqui - Thomas Jefferson University HospitalMegan Murphy - Thomas Jefferson UniversityRobert Lam - Thomas Jefferson UniversityMeet Parikh - Thomas Jefferson Univ Hosp, Dept Gastroenterol, Philadelphia, PA 19107 USADouglas Pleskow - Beth Israel Deaconess Medical CenterGeorgios Papachristou - University of PittsburghReem Sharaiha - Weill Cornell MedicineUsama Iqbal - Drexel University, Gastroenterology and HepatologyDavid Loren - Thomas Jefferson University HospitalThomas Kowalski - Thomas Jefferson UniversityArish Noor - Thomas Jefferson University HospitalTayebah Mumtaz - Geisinger Health SystemIchiro Yasuda - Teikyo UniversitySamuel Thomas - University of UtahAbdul Hsaeeb - University of UtahJennifer Herrick - University of UtahTom Greene - University of UtahDouglas G. Adler - University of Utah
- Publication Details
- Annals of gastroenterology, v 33(2), pp 202-209
- Publisher
- Hellenic Soc Gastroenterology
- Number of pages
- 10
- Grant note
- UL1 TR001863 / NCATS NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Gastroenterology and Hepatology
- Web of Science ID
- WOS:000519613000012
- Scopus ID
- 2-s2.0-85081250146
- Other Identifier
- 991021860774204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Gastroenterology & Hepatology