Efficacy of endoscopic over 3-branched partial stent-in-stent drainage using self-expandable metallic stents in patients with unresectable hilar biliary carcinoma

Daisuke Uchida, Hironari Katou, Shinichiro Muro, Yasuhiro Noma, Naoki Yamamoto, Shigeru Horiguchi, Ryo Harada, Koichiro Tsutsumi, Hirofumi Kawamoto, Hiroyuki Okada, Kazuhide Yamamoto

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Background: The treatment of biliary stricture is crucially important for continuing stable chemotherapy for unresectable biliary carcinoma; however, there is no consensus regarding the use of hilar biliary drainage. In this study, we examined the efficacy of endoscopic over 3-branched biliary drainage using self-expandable metallic stents (SEMSs) in patients with unresectable malignant hilar biliary stricture (HBS). Methods: A total of 77 patients with unresectable HBS treated with a SEMS and chemotherapy were retrospectively reviewed. There were 59 patients with cholangiocarcinoma and 18 patients with gallbladder carcinoma. The patients were divided into 2 groups (4- or 3-branched group and 2- or 1-branched group) and compared with respect to the duration of stent patency and overall survival. Results: A comparison of the patients' baseline characteristics showed no significant differences between the 4- or 3-branched group and the 2- or 1-branched group. Neither the duration of patency nor survival time exhibited significant differences between the 2 groups, although, among the patients achieving disease control, the duration of patency period and survival time of the 4- or 3-branched group were significantly higher than those observed in the 2- or 1-branched group (P=0.0231 and 0.0466). Conclusions: The use of endoscopic over 3-branched biliary drainage with a SEMS may improve the duration of patency in patients with HBS.

Original languageEnglish
Pages (from-to)529-536
Number of pages8
JournalJournal of Clinical Gastroenterology
Issue number6
Publication statusPublished - Jun 24 2015



  • biliary drainage
  • hilar biliary stricture
  • metallic stent
  • multistenting

ASJC Scopus subject areas

  • Gastroenterology

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