caa a22 4500 445888016 CHVBK 20180317145605.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1007/s00535-011-0383-0 doi (NATIONALLICENCE)springer-10.1007/s00535-011-0383-0 Multicenter study evaluating factors for stent patency in patients with malignant biliary strictures: development of a simple score model [Elektronische Daten] [Petra van Boeckel, Ewout Steyerberg, Frank Vleggaar, Marcel Groenen, Ben Witteman, Bas Weusten, Han Geldof, Adriaan Tan, Marina Grubben, Jan Nicolai, Peter Siersema] Background: Self-expanding metal stents (SEMS) are known to have a significantly higher patency rate than plastic stents. We aimed to identify prognostic factors, besides stent type, for stent patency and to develop a score model that could further aid in guiding stent choice for the palliation of a malignant biliary stricture. Methods: A retrospective multicenter study was conducted. Data on consecutive patients who had a stent placed between January 2002 and July 2009 were collected. Cumulative stent occlusion rates were analyzed by Kaplan-Meier curves and log rank testing, and prognostic factors were assessed by Cox regression analysis. Results: A total of 690 stents (512 plastic stents, 174 SEMS) were endoscopically placed in 390 patients. At 8weeks, stent occlusion had occurred in 32% of the plastic stents and 11% of the SEMS. Multivariate analysis indicated that plastic stents (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.9-3.5), a tight stricture requiring preceding dilation (HR 1.8, 95% CI 1.3-2.5), and a high initial bilirubin level (>50μmol/L (HR 1.3, 95% CI 1.0-1.7) were independently associated with an increased risk of stent occlusion. A score model based on these 3 factors was able to distinguish between stent procedures with a relatively high and low risk of stent occlusion (median 14 vs. 26weeks, respectively). Conclusion: Besides plastic stents, stricture severity requiring preceding dilation, and initial higher bilirubin level were associated with a shorter period of stent patency. A simple score model based on these factors was able to predict stent occlusion and may aid in choosing the most appropriate stent type in individual patients. Springer, 2011 Plastic stent nationallicence Metal stent nationallicence Malignant biliary obstruction nationallicence Stent patency nationallicence Score model nationallicence van Boeckel Petra Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Room F02.618, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands aut Steyerberg Ewout Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aut Vleggaar Frank Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Room F02.618, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands aut Groenen Marcel Department of Gastroenterology, Ziekenhuis Rijnstate, Arnhem, The Netherlands aut Witteman Ben Department of Gastroenterology, Ziekenhuis Gelderse Vallei, Ede, The Netherlands aut Weusten Bas Department of Gastroenterology, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands aut Geldof Han Department of Gastroenterology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands aut Tan Adriaan Department of Gastroenterology, IJsselland Ziekenhuis, Capelle a/d IJssel, The Netherlands aut Grubben Marina Department of Gastroenterology, Elizabeth Ziekenhuis, Tilburg, The Netherlands aut Nicolai Jan Department of Gastroenterology, Hagaziekenhuis, The Hague, The Netherlands aut Siersema Peter Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Room F02.618, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands aut Journal of Gastroenterology Springer Japan 46/9(2011-09-01), 1104-1110 0944-1174 46:9<1104 2011 46 535 https://doi.org/10.1007/s00535-011-0383-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-011-0383-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- van Boeckel Petra Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Room F02.618, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Steyerberg Ewout Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Vleggaar Frank Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Room F02.618, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Groenen Marcel Department of Gastroenterology, Ziekenhuis Rijnstate, Arnhem, The Netherlands aut NATIONALLICENCE 700 1- Witteman Ben Department of Gastroenterology, Ziekenhuis Gelderse Vallei, Ede, The Netherlands aut NATIONALLICENCE 700 1- Weusten Bas Department of Gastroenterology, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands aut NATIONALLICENCE 700 1- Geldof Han Department of Gastroenterology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Tan Adriaan Department of Gastroenterology, IJsselland Ziekenhuis, Capelle a/d IJssel, The Netherlands aut NATIONALLICENCE 700 1- Grubben Marina Department of Gastroenterology, Elizabeth Ziekenhuis, Tilburg, The Netherlands aut NATIONALLICENCE 700 1- Nicolai Jan Department of Gastroenterology, Hagaziekenhuis, The Hague, The Netherlands aut NATIONALLICENCE 700 1- Siersema Peter Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Room F02.618, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/9(2011-09-01), 1104-1110 0944-1174 46:9<1104 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer