TY - JOUR
T1 - Cholecystitis After Metallic Stent Placement in Patients With Malignant Distal Biliary Obstruction
AU - Isayama, Hiroyuki
AU - Kawabe, Takao
AU - Nakai, Yousuke
AU - Tsujino, Takeshi
AU - Sasahira, Naoki
AU - Yamamoto, Natsuyo
AU - Arizumi, Toshihiko
AU - Togawa, Osamu
AU - Matsubara, Saburou
AU - Ito, Yukiko
AU - Sasaki, Takashi
AU - Hirano, Kenji
AU - Toda, Nobuo
AU - Komatsu, Yutaka
AU - Tada, Minoru
AU - Yoshida, Haruhiko
AU - Omata, Masao
PY - 2006/9
Y1 - 2006/9
N2 - Background & Aims: Cholecystitis after metallic stent (MS) placement is an issue requiring attention. From our experience, cholecystitis seemed to occur mainly in patients with tumor involvement to the cystic duct orifice. The aim of the present study was to identify risk factors for cholecystitis in patients treated with covered or uncovered MS. Methods: We analyzed 246 patients who received MS placement (covered MS in 171 and uncovered in 75) between August 1997 and May 2005 for the treatment of unresectable distal malignant biliary obstruction. Causative diseases were as follows: pancreatic cancer in 162, papillary cancer in 10, bile duct cancer in 41, and metastatic nodes in 33 patients. Tumor involvement to orifice of the cystic duct (OCD) was diagnosed based on cholangiography and intraductal ultrasonography. Results: Cholecystitis after MS placement was found in 13 patients (5.3%). There was no significant difference in the incidence of cholecystitis between covered (5.8%) and uncovered (4.0%) MS. By univariate analysis, tumor involvement of the OCD, MS placed above the papilla, and stricture located at midportion were associated significantly with cholecystitis. By multivariate analysis, only tumor involvement of the OCD was a risk factor, with an odds ratio of 47.206 (95% confidence interval, 5.84-381.60). Conclusions: Cholecystitis after MS placement is associated with tumor involvement to the orifice of the cystic duct, regardless of the type of stent.
AB - Background & Aims: Cholecystitis after metallic stent (MS) placement is an issue requiring attention. From our experience, cholecystitis seemed to occur mainly in patients with tumor involvement to the cystic duct orifice. The aim of the present study was to identify risk factors for cholecystitis in patients treated with covered or uncovered MS. Methods: We analyzed 246 patients who received MS placement (covered MS in 171 and uncovered in 75) between August 1997 and May 2005 for the treatment of unresectable distal malignant biliary obstruction. Causative diseases were as follows: pancreatic cancer in 162, papillary cancer in 10, bile duct cancer in 41, and metastatic nodes in 33 patients. Tumor involvement to orifice of the cystic duct (OCD) was diagnosed based on cholangiography and intraductal ultrasonography. Results: Cholecystitis after MS placement was found in 13 patients (5.3%). There was no significant difference in the incidence of cholecystitis between covered (5.8%) and uncovered (4.0%) MS. By univariate analysis, tumor involvement of the OCD, MS placed above the papilla, and stricture located at midportion were associated significantly with cholecystitis. By multivariate analysis, only tumor involvement of the OCD was a risk factor, with an odds ratio of 47.206 (95% confidence interval, 5.84-381.60). Conclusions: Cholecystitis after MS placement is associated with tumor involvement to the orifice of the cystic duct, regardless of the type of stent.
UR - https://www.scopus.com/pages/publications/33748170114
U2 - 10.1016/j.cgh.2006.06.004
DO - 10.1016/j.cgh.2006.06.004
M3 - 記事
C2 - 16904950
AN - SCOPUS:33748170114
SN - 1542-3565
VL - 4
SP - 1148
EP - 1153
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 9
ER -
