Efficacy and Safety of Metallic Stents in Patients With Unresectable Pancreatic Cancer Receiving Gemcitabine

Nakai, Yousuke; Isayama, Hiroyuki; Kawabe, Takao; Tsujino, Takeshi; Yoshida, Haruhiko; Sasaki, Takashi; Tada, Minoru; Arizumi, Toshihiko; Yagioka, Hiroshi; Kogure, Hirofumi; Togawa, Osamu; Ito, Yukiko; Matsubara, Saburou; Hirano, Keisuke; Sasahira, Naoki; Omata, Masao

doi:10.1097/mpa.0b013e3181706d93

Cited by 21 publications

(13 citation statements)

References 23 publications

(16 reference statements)

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“…In direct contrast, systemic gemcitabine had no effects on stent patency or patient survival in the present study. Nakai et al 27. reported that gemcitabine-based systemic chemotherapy had no effects on stent-related complications or stent patency.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a Multiplex Paclitaxel Emission Stent Using a Pluronic^® Mixture Membrane versus a Covered Metal Stent in Malignant Biliary Obstruction: A Prospective Randomized Comparative Study

et al. 2017

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Background/AimsA drug-eluting stent for unresectable malignant biliary obstruction was developed to increase stent patency by preventing tumor ingrowth. The safety and efficacy of a new generation of metallic stents covered with a paclitaxel-incorporated membrane using a Pluronic® mixture (MSCPM-II) were compared prospectively with those of covered metal stents (CMSs) in patients with malignant biliary obstructions.MethodsThis study was initially designed as a prospective randomized trial but was closed early because of a high incidence of early occlusion. Therefore, the data were analyzed using the intent-to-treat method. A total of 72 patients with unresectable distal malignant biliary obstructions were prospectively enrolled.ResultsThe two groups did not differ significantly in basic characteristics and mean follow-up period (MSCPM-II 194 days vs CMS 277 days, p=0.063). Stent occlusion occurred in 14 patients (35%) who received MSCPM-II and in seven patients (21.9%) who received CMSs. Stent patency and survival time did not significantly differ between the two groups (p=0.355 and p=0.570). The complications were mild and resolved by conservative management in both groups.ConclusionsThere were no significant differences in stent patency or patient survival in MSCPM-II and CMS patients with malignant biliary obstructions.

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Section: Discussionmentioning

confidence: 99%

Efficacy of a Multiplex Paclitaxel Emission Stent Using a Pluronic^® Mixture Membrane versus a Covered Metal Stent in Malignant Biliary Obstruction: A Prospective Randomized Comparative Study

et al. 2017

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“…In patients with unresectable pancreatic cancer, gemcitabine chemotherapy did not increase stent occlusion or stent‐related complications of SEMS. However, stent migration tended to be higher in the gemcitabine group (17% vs 3%) . In a further recent, large‐scale study of 291 biliary stents (151 SEMS and 140 PS), stent patency was comparable in cases with and without chemo (radio)therapy .…”

Section: Methodsmentioning

confidence: 99%

International consensus statements for endoscopic management of distal biliary stricture

Nakai

Isayama

Wang

et al. 2020

J of Gastro and Hepatol

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103

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Distal biliary strictures (DBS) are common and may be caused by both malignant and benign pathologies. While endoscopic procedures play a major role in their management, a comprehensive review of the subject is still lacking. Our consensus statements were formulated by a group of expert Asian pancreatico‐biliary interventional endoscopists, following a proposal from the Digestive Endoscopy Society of Taiwan, the Thai Association for Gastrointestinal Endoscopy, and the Tokyo Conference of Asian Pancreato‐biliary Interventional Endoscopy. Based on a literature review utilizing Medline, Cochrane library, and Embase databases, a total of 19 consensus statements on DBS were made on diagnosis, endoscopic drainage, benign biliary stricture, malignant biliary stricture, and management of recurrent biliary obstruction and other complications. Our consensus statements provide comprehensive guidance for the endoscopic management of DBS.

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“…C-SEMSs and their antimigration properties have been evaluated in patients with benign pancreatobiliary strictures and malignant biliary obstruction. An improved prognosis in accordance with the recent development of chemotherapy will necessitate C-SEMS with longer patency without stent migration 3,4…”

Section: Introductionmentioning

confidence: 99%

A Novel, Fully Covered Laser-Cut Nitinol Stent with Antimigration Properties for Nonresectable Distal Malignant Biliary Obstruction: A Multicenter Feasibility Study

Isayama¹,

Kawakubo²,

Nakai³

et al. 2013

Gut Liver

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Background/AimsStent migration occurs frequently, but the prevention of complications resulting from covered self-expandable metal stents (C-SEMSs) remains unresolved. We prospectively assessed a newly developed C-SEMS, a modified covered Zeo stent (m-CZS), in terms of its antimigration effect.MethodsBetween February 2010 and January 2011, an m-CZS was inserted into 42 patients (31 initial drainage cases and 11 reintervention cases) at a tertiary referral center and three affiliated hospitals. The laser-cut stent was flared for 1.5 cm at both ends, with a 1 cm raised bank located 1 cm in from each flared end. The main outcome of this study was the rate of stent migration, and secondary outcomes were the rate of recurrent biliary obstruction (RBO), the time to RBO, the frequencies of complications, and overall survival.ResultsOf the 31 patients with initial drainage, stent migration occurred in four (12.9%, 95% confidence interval, 5.1% to 29.0%), with a mean time of 131 days. RBO occurred in 18 (58%), with a median time to RBO of 107 days. Following previous C-SEMS migration, seven of 10 patients (70%) did not experience m-CZS migration until death.Conclusionsm-CZSs with antimigration properties effectively, although not completely, prevented stent migration after stent insertion.

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Efficacy and Safety of Metallic Stents in Patients With Unresectable Pancreatic Cancer Receiving Gemcitabine

Abstract: Expandable metallic stent placement is safe and effective in patients with unresectable pancreatic cancer receiving GEM. Gemcitabine improves survival irrespective of EMS placement.

Cited by 21 publications

References 23 publications

Efficacy of a Multiplex Paclitaxel Emission Stent Using a Pluronic^® Mixture Membrane versus a Covered Metal Stent in Malignant Biliary Obstruction: A Prospective Randomized Comparative Study

Efficacy of a Multiplex Paclitaxel Emission Stent Using a Pluronic^® Mixture Membrane versus a Covered Metal Stent in Malignant Biliary Obstruction: A Prospective Randomized Comparative Study

International consensus statements for endoscopic management of distal biliary stricture

A Novel, Fully Covered Laser-Cut Nitinol Stent with Antimigration Properties for Nonresectable Distal Malignant Biliary Obstruction: A Multicenter Feasibility Study

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Efficacy and Safety of Metallic Stents in Patients With Unresectable Pancreatic Cancer Receiving Gemcitabine

Abstract: Expandable metallic stent placement is safe and effective in patients with unresectable pancreatic cancer receiving GEM. Gemcitabine improves survival irrespective of EMS placement.

Cited by 21 publications

References 23 publications

Efficacy of a Multiplex Paclitaxel Emission Stent Using a Pluronic® Mixture Membrane versus a Covered Metal Stent in Malignant Biliary Obstruction: A Prospective Randomized Comparative Study

Efficacy of a Multiplex Paclitaxel Emission Stent Using a Pluronic® Mixture Membrane versus a Covered Metal Stent in Malignant Biliary Obstruction: A Prospective Randomized Comparative Study

International consensus statements for endoscopic management of distal biliary stricture

A Novel, Fully Covered Laser-Cut Nitinol Stent with Antimigration Properties for Nonresectable Distal Malignant Biliary Obstruction: A Multicenter Feasibility Study

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Efficacy of a Multiplex Paclitaxel Emission Stent Using a Pluronic^® Mixture Membrane versus a Covered Metal Stent in Malignant Biliary Obstruction: A Prospective Randomized Comparative Study

Efficacy of a Multiplex Paclitaxel Emission Stent Using a Pluronic^® Mixture Membrane versus a Covered Metal Stent in Malignant Biliary Obstruction: A Prospective Randomized Comparative Study