頁籤選單縮合
題名 | Predictors of Stent Occlusion in Patients with Unresectable Pancreatic Cancer after Biliary Metal Stents= |
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作者 | Lin, Xi-hsuan; Ting, Po-hsiang; Luo, Jiing-chyuan; Lee, Kuei-chuan; Chen, Tseng-shing; Huang, Yi-hsiang; Hou, Ming-chih; Lee, Fa-yauh; |
期刊 | Journal of the Chinese Medical Association |
出版日期 | 20191000 |
卷期 | 82:10 2019.10[民108.10] |
頁次 | 頁762-766 |
分類號 | 415.456 |
語文 | eng |
關鍵詞 | Malignant biliary obstruction; Pancreatic cancer; Partially covered self-expandable metal stent; Stent occlusion; |
英文摘要 | Background: Self-expandable metal stents (SEMS) are a widely accepted biliary endoprosthesis for patients with unresectable malignant biliary obstruction. Here, we identified predictors for the occlusion of SEMS in unresectable pancreatic cancer patients with biliary tract obstruction. Methods: Patients with a distal malignant biliary obstruction caused by unresectable pancreatic cancer who received partially covered SEMS (PC-SEMS) placement for the first time between January 2003 and January 2016 were retrospectively enrolled for analysis. The rates of PC-SEMS occlusion were evaluated. The possible predictors of PC-SEMS occlusion were analyzed using Cox regression analysis. Results: In total, 120 patients who received PC-SEMS for unresectable pancreatic cancer were identified. The rate of PC-SEMS occlusion was 37%. The median time to occlusion of PC-SEMS was 359 days. The major causes of occlusion included biliary sludge (61%) and tumor ingrowth (30%). Cox multivariate regression analysis revealed that inadequate alkaline phosphatase/ gamma-glutamyl transferase decline (defined by a decrease of <50% within 2wk after PC-SEMS placement) was the only independent predictor of stent occlusion (hazard ratio, 2.86; 95% CI, 1.28-6.25; p = 0.01) Conclusion: Inadequate alkaline phosphatase/gamma-glutamyl transferase decline is a predictor of occlusion of first-time PC-SEMS placement in unresectable pancreatic cancer patients with biliary tract obstruction. |
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