caa a22 4500 445796731 CHVBK 20180317145128.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s10620-010-1550-5 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1550-5 Optimum Palliation of Inoperable Hilar Cholangiocarcinoma: Comparative Assessment of the Efficacy of Plastic and Self-Expanding Metal Stents [Elektronische Daten] [Ramu Raju, Sathya Jaganmohan, William Ross, Marta Davila, Milind Javle, Gottumukkala Raju, Jeffrey Lee] Background: Endoscopic retrograde biliary drainage (ERBD) with plastic or self-expanding metal stents (SEMS) is often performed for palliative care for cholangiocarcinoma. Objective: The objective was to compare the clinical effectiveness, including stent patency, complication rate, and need for salvage percutaneous transhepatic biliary drainage, of SEMS and plastic stents. Methods: A total of 100 patients with inoperable cholangiocarcinoma were identified from an endoscopic database from 1/1/01 to 9/30/06 at a tertiary cancer hospital and their clinical history was retrospectively reviewed. All patients were followed to death, re-intervention, or for at least one year. Stent patency and patient survival were estimated by Kaplan-Meier analysis, supplemented by the log-rank test for comparisons between groups. Results: Forty-eight patients had SEMS placed and 52 patients had plastic stents placed. ERBD was successful in 46 (95.8%) in the SEMS group and 49 (94.2%) in the plastic group (P=0.67). Median patency times were 1.86months in the plastic group and 5.56months in the SEMS group (P<0.0001). A mean of 1.53 and 4.60 re-interventions were performed in the SEMS and plastic groups, respectively (P<0.05). Complications occurred in 4/48 (8.3%) in the SEMS group and 4/52 (7.7%) in the plastic group (P=0.79). Median survival was 9.08 and 8.22months in the SEMS and plastic stent groups, respectively (P=0.50). Conclusion: Metallic stent patency was superior to that of plastic stents in all Bismuth-Corlette classifications of hilar cholangiocarcinoma with similar complication rates. SEMS seem to be cost-effective and, when feasible, should be considered as an initial intervention in patients with inoperable hilar cholangiocarcinoma. Springer Science+Business Media, LLC, 2011 Cholangiocarinoma nationallicence Endoscopic palliation nationallicence Biliary stenting nationallicence Malignant hilar biliary obstruction nationallicence Raju Ramu Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut Jaganmohan Sathya Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut Ross William Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut Davila Marta Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut Javle Milind Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA aut Raju Gottumukkala Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut Lee Jeffrey Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/5(2011-05-01), 1557-1564 0163-2116 56:5<1557 2011 56 10620 https://doi.org/10.1007/s10620-010-1550-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1550-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Raju Ramu Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut NATIONALLICENCE 700 1- Jaganmohan Sathya Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut NATIONALLICENCE 700 1- Ross William Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut NATIONALLICENCE 700 1- Davila Marta Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut NATIONALLICENCE 700 1- Javle Milind Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Raju Gottumukkala Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut NATIONALLICENCE 700 1- Lee Jeffrey Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1466, 77030-4009, Houston, TX, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/5(2011-05-01), 1557-1564 0163-2116 56:5<1557 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer