Efficacy and safety of a novel anti-reflux metal stent during neoadjuvant chemotherapy for pancreatic cancer: A prospective multicenter exploratory study.

Abstract

BACKGROUND/PURPOSE:

The benefits of anti-reflux metal stents, used for treating biliary obstruction in patients receiving neoadjuvant chemotherapy (NAC) for pancreatic cancer, are yet unknown. Herein, the safety and efficacy of the novel duckbill-type anti-reflux metal stent (D-ARMS) were prospectively evaluated for biliary drainage. Additionally, the incidence of recurrent biliary obstruction (RBO) after placement of D-ARMS vs conventional covered self-expandable metal stents (CCSEMSs) was retrospectively compared.

METHODS:

Patients who received D-ARMS (n = 33) for treatment of distal biliary obstruction before NAC between September 2019 and January 2021 and those that received CCSEMSs (n = 38) between January 2013 and August 2019 were included in the historical control group. Technical and clinical successes, rate of RBO, and cumulative incidence of RBO were compared between the two groups.

RESULTS:

The technical success rate was 100% for both the D-ARMS and CCSEMS groups, and the clinical success rate were not significantly different (93.9% and 89.5%, respectively; P = .68). In the multivariate analysis, D-ARMS was identified as the independent factor for cumulative incidence of RBO (P = .03). The cumulative incidence of RBO was significantly lower in the D-ARMS group than that in the CCSEMS group (P = .04).

CONCLUSIONS:

D-ARMS is safe and effective for patients receiving NAC.

• Authors: Makoto Hinokuchi, Shinichi Hashimoto, Issei Kojima, Yoshitaka Nakamura, Toshihiro Fujita, Yuji Iwashita, Shiho Arima, Shiroh Tanoue, Takao Ohtsuka, Akio Ido
• Journal: Journal of hepato-biliary-pancreatic sciences (J Hepatobiliary Pancreat Sci) Vol. 30 Issue 4 Pg. 532-541 (Apr 2023) ISSN: 1868-6982 [Electronic] Japan
• PMID: 36106919 (Publication Type: Multicenter Study, Journal Article)
• Copyright: © 2022 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Topics

• Humans
• Prospective Studies
• Neoadjuvant Therapy
• Retrospective Studies
• Stents (adverse effects)
• Pancreatic Neoplasms (therapy, complications)
• Cholestasis (etiology)
• Pancreatic Neoplasms