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肝門部悪性胆道閉塞に対する金属ステントの両葉留置成功に関する因子の検討
http://hdl.handle.net/10232/00031140
http://hdl.handle.net/10232/00031140076e1ca8-f190-41e8-8da4-523108a51882
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Diss_藤田_俊浩_ISK566_2020 (1.6 MB)
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Abstract_藤田_俊浩_4512800053_2020 (165.8 kB)
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Result_Fujita_Toshihiro_isk_566 (1.1 MB)
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Comments_Fujita_Toshihiro_isk_566 (425.5 kB)
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| Item type | 学位論文 / Thesis or Dissertation(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2020-08-19 | |||||
| タイトル | ||||||
| タイトル | Factors Associated with the Technical Success of Bilateral Endoscopic Metallic Stenting with Partial Stent-In-Stent Placement in Patients with Malignant Hilar Biliary Obstruction | |||||
| 言語 | en | |||||
| タイトル | ||||||
| タイトル | 肝門部悪性胆道閉塞に対する金属ステントの両葉留置成功に関する因子の検討 | |||||
| 言語 | ja | |||||
| 著者 |
藤田, 俊浩
× 藤田, 俊浩 |
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| 言語 | ||||||
| 言語 | eng | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||
| 資源タイプ | doctoral thesis | |||||
| アクセス権 | ||||||
| アクセス権 | open access | |||||
| アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||
| 要約(Abstract) | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | Background. Bilateral biliary drainage decreases the risk of cholangitis, but bilateral endoscopic metallic stenting is technically challenging. Aim. We retrospectively evaluated the factors associated with successful bilateral self-expanding metal stent (SEMS) placement using the partial stent-in-stent (PSIS) method for malignant hilar biliary obstruction and also assessed the safety and efficacy of this technique. Methods. From April 2010 to February 2016, 47 consecutive patients (mean age, 73 0 ± 8 6 years; 32 males and 15 females) underwent PSIS placement for malignant hilar biliary obstruction in our hospital. The technical success of PSIS, clinical response, and complications were investigated. Factors associated with the technical success of PSIS were assessed. Using a propensity score-matched analysis, we compared the procedure time, clinical response, complications, stent patency, and survival time in 17 matched patients treated with bilateral SEMS placement using a SEMS delivery system of <6.0 or ≥6.0 Fr. Results. The technical success rate was 77%. The clinical response rate was 91%, and the complication rate was 26%. Regarding complications, pancreatitis occurred in 5 patients (11%), cholangitis in 6 (13%), and cholecystitis in 1 (2%). A multiple logistic regression analysis identified the use of a SEMS with a delivery system < 6 0Fr as a factor associated with technical success (P = 0 033; odds ratio, 10.769; 95% confidence interval, 1.205-96.212). In the 17 matched patients assigned according to the SEMS delivery system size, the procedure time was significantly shorter in those with a delivery system size < 6 0Fr than in those with ≥6.0 Fr (P < 0 01). There were no significant differences in the clinical response, complication rate, stent patency, or survival time between the two groups. Conclusion. Using a delivery system < 6 0Fr in size helped improve the technical success and reduced the procedure time for the placement of a SEMS by the PSIS method. Toshihiro Fujita, Shinichi Hashimoto , Shiroh Tanoue, Kengo Tsuneyoshi, Yoshitaka Nakamura, Makoto Hinokuchi, Hiromichi Iwaya, Shiho Arima, Yuji Iwashita, Fumisato Sasaki, Hiroki Taguchi, Shuji Kanmura, and Akio Ido Factors Associated with the Technical Success of Bilateral Endoscopic Metallic Stenting with Partial Stent-In-Stent Placement in Patients with Malignant Hilar Biliary Obstruction hindawi (2019) Article ID 5928040 https://doi.org/10.1155/2019/5928040 |
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| 言語 | en | |||||
| 作成日 | ||||||
| 日付 | 2020-07-03 | |||||
| 日付タイプ | Collected | |||||
| 出版タイプ | ||||||
| 出版タイプ | VoR | |||||
| 出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
| NDC | ||||||
| 主題Scheme | NDC | |||||
| 主題 | 490 | |||||
| ファイル（説明） | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | 博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨 | |||||
| 言語 | ja | |||||
| 公開者・出版者 | ||||||
| 出版者 | hindawi | |||||
| 言語 | en | |||||
| 公開者・出版者 | ||||||
| 出版者 | 鹿児島大学 | |||||
| 言語 | ja | |||||
| 公開者・出版者 | ||||||
| 出版者 | カゴシマ ダイガク | |||||
| 言語 | ja-Kana | |||||
| 備考 | ||||||
| 値 | 【指導教員:井戸章雄】 | |||||
| date.appl | ||||||
| 値 | 【学位申請日】2020-04-01 | |||||
| 学位名 | ||||||
| 言語 | ja | |||||
| 学位名 | 博士(医学) | |||||
| 学位名 | ||||||
| 言語 | en | |||||
| 学位名 | Doctor of Philosophy in Medical Science | |||||
| 学位授与機関 | ||||||
| 学位授与機関識別子Scheme | kakenhi | |||||
| 学位授与機関識別子 | 17701 | |||||
| 言語 | ja | |||||
| 学位授与機関名 | 鹿児島大学 | |||||
| 学位授与年月日 | ||||||
| 学位授与年月日 | 2020-07-15 | |||||
| 学位授与番号 | ||||||
| 学位授与番号 | 甲総研第566号 | |||||
