| 악성 원위부 담관 폐쇄 시 피막형 금속 스텐트와 비피막형 금속 스텐트의 비교 |
| 윤원재·이광혁·이준규·류지곤·김용태·이우진*·윤용범 |
| 서울대학교 의과대학 내과학교실, *국립암센터 간암센터 |
| A Comparison of Covered Expandable Metal Stent and Uncovered Expandable Metal Stent for the Management of Distal Malignant Biliary Obstruction |
| Won Jae Yoon, M.D., Kwang Hyuck Lee, M.D., Jun Kyu Lee, M.D., Ji Kon Ryu, M.D., Yong-Tae Kim, M.D., Woo Jin Lee, M.D.* and Yong Bum Yoon, M.D. |
| Department of Internal Medicine, Seoul National University College of Medicine, Seoul, *Center for Liver Cancer, National Cancer Center, Ilsan, Korea |
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| Abstract |
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Background/Aims:
Covered self-expandable metal stents (CEMS) were developed to overcome tumor ingrowth which is a problem of uncovered EMS (UEMS). However, the efficacy of CEMS is controversial, and CEMS have problems such as migration and development of cholecystitis.
Methods:
We evaluated 77 cases of endoscopic retrograde biliary drainage using EMS for unresectable distal malignant biliary obstruction in a retrospective setting. Polyurethane-covered Wallstents were used on 36 patients and uncovered Wallstents were used on 41 patients. Early complications and stent patency were analyzed. The end points of this study were stent obstruction or death of the patient.
Results:
Stent migration occurred in three of the CEMS group and one of the UEMS group. Cholecystitis occurred in one of the CEMS group but in none of the UEMS group. Acute pancreatitis and bleeding did not occur in both groups. Stent occlusion occurred after a mean of 271 days in the CEMS group and 263 days in the UEMS group.
Conclusions:
Stent patency was comparable between covered and uncovered Wallstent. A large-scale prospective randomized study is needed to evaluate the efficacy and indication of covered Wallstent. (Korean J Gastrointest Endosc 2005;30:257261) |
| Key Words:
Stents, Biliary tract neoplasms, Biliary obstruction |
| 주요어:
스텐트, 담관계 종양, 담관 폐쇄 |
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