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Propensity score matching analysis for clinical impact of braided-type versus laser-cut-type covered self-expandable metal stents for endoscopic ultrasound-guided hepaticogastrostomy

摘要Background:To prevent stent migration during endoscopic ultrasound-guided hepaticogastrostomy(EUS-HGS),intra-scope channel release technique is important,but is unfamiliar to non-expert hands.The self-expandable metal stent(SEMS)is an additional factor to prevent stent migration.However,no compara-tive studies of laser-cut-type and braided-type during EUS-HGS have been reported.The aim of this study was to compare the distance between the intrahepatic bile duct and stomach wall after EUS-HGS among laser-cut-type and braided-type SEMS.Methods:To evaluate stent anchoring function,we measured the distance between the hepatic parenchyma and stomach wall before EUS-HGS,one day after EUS-HGS,and 7 days after EUS-HGS.Also,propensity score matching was performed to create a propensity score for using laser-cut-type group and braided-type group.Results:A total of 142 patients were enrolled in this study.Among them,24 patients underwent EUS-HGS using a laser-cut-type SEMS,and 118 patients underwent EUS-HGS using a braided-type SEMS.EUS-HGS using the laser-cut-type SEMS was mainly performed by non-expert endoscopists(n=21);EUS-HGS using braided-type SEMS was mainly performed by expert endoscopists(n=98).The distance after 1 day was significantly shorter in the laser-cut-type group than that in the braided-type group[2.00(1.70-3.75)vs.6.90(3.72-11.70)mm,P<0.001].In addition,this distance remained significantly shorter in the laser-cut-type group after 7 days.Although these results were similar after propensity score matching analysis,the distance between hepatic parenchyma and stomach after 7 days was increased by 4 mm compared with the distance after 1 day in the braided-type group.On the other hand,in the laser-cut-type group,the distance after 1 day and 7 days was almost the same.Conclusions:EUS-HGS using a laser-cut-type SEMS may be safe to prevent stent migration,even in non-expert hands.

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作者 Mitsuki Tomita [1] Takeshi Ogura [2] Akitoshi Hakoda [3] Saori Ueno [1] Atsushi Okuda [1] Nobu Nishioka [1] Yoshitaro Yamamoto [1] Hiroki Nishikawa [1] 学术成果认领
作者单位 2nd Department of Internal Medicine,Osaka Medical and Pharmaceutical University,Osaka,Japan [1] 2nd Department of Internal Medicine,Osaka Medical and Pharmaceutical University,Osaka,Japan;Endoscopy Center,Osaka Medical and Pharmaceutical University,Osaka,Japan [2] Endoscopy Center,Osaka Medical and Pharmaceutical University,Osaka,Japan [3]
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DOI 10.1016/j.hbpd.2023.08.006
发布时间 2024-05-13(万方平台首次上网日期,不代表论文的发表时间)
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国际肝胆胰疾病杂志(英文版)

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