Korean Journal of Gastrointestinal Endoscopy 2009;39(3): 149-153.
폐쇄된 담도 금속관 치료에서 피막형 및 비피막형 금속관의 유용성 비교
정경식ㆍ정우진ㆍ김동욱ㆍ최철웅ㆍ강대환
부산대학교 의학전문대학원 내과학교실
Management of Occluded Biliary Uncovered Metal Stents: Covered Self Expandable Metallic Stent vs. Uncovered Self Expandable Metallic Stent
Kyung Sik Jung, M.D., Woo Jin Jung, M.D., Dong Uk Kim, M.D., Cheul Woong Choi, M.D. and Dae Hwan Kang, M.D.
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
Abstract
Background/Aims: Unresectable malignant biliary obstruction has usually been treated by placement of a self-expandable metallic stent (SEMS). One of the major complications of SEMS is occlusion of the stent by the ingrowth and overgrowth of tumor. The optimal management of an occluded SEMS is still an unresolved problem. We performed this study to evaluate the usefulness of placing a second stent with using an uncovered SEMS or a covered SEMS in patients with stent occlusion.
Methods: From January 2006 to December 2007, a total of 163 patients were treated with the placement of an uncovered SEMS for treating malignant biliary obstruction, except for the cases with Klatskin's tumor. Thirty four patients were occluded and they underwent a second SEMS insertion. All the patients with an occluded uncovered SEMS were managed with placement of a covered SEMS or an uncovered SEMS by ERCP.
Results: The median patent duration after intervention was 98 days (range: 8∼300 days) after the second covered SEMS insertion, and the median patent duration after intervention was 90 days (range: 10∼643 days) after the second uncovered SEMS insertion. No significant difference in the patent period was observed between the covered SEMS group and the uncovered SEMS group (P=0.832).
Conclusions: The covered SEMS group and the uncovered SEMS group had similar patent periods for the management of occluded uncovered metal stents. (Korean J Gastrointest Endosc 2009;39:149-153)
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