RISK FACTORS FOR INEFFECTIVE FUNCTIONING OF UNCOVERED BILIARY STENTS WITH HIGH MALIGNANT BILIARY OBSTRUCTION

Abstract

The purpose of a single-center retrospective study: to identify risk factors that contribute to the ineffective drainage of the biliary tract during antegrade stenting uncovered by self-expanding vzbo stent. In the surgical clinic of the Botkin Hospital (Moscow) for the period from 2009 to 2017. Stenting was performed in 54 patients with VzBO. The average age was 73.2 ± 5.3 years; the average level of bilirubinemia - 294.2 ± 10.1 µmol / l; VzBO level: Bismuth II - 11, Bismuth III - 43; comorbid background: associated cholangitis - 9 (16.7%); concomitant cirrhosis - 7 (12.9%). 28 had side-by-side stenting, 15 Y-stenting, 11 stenting of the common hepatic duct with one stent. The causes of zVBO were: portal cholangiocarcinoma 23 (42.6%), intrahepatic cholangiocarcinoma 16 (29.6%), gallbladder cancer 9 (16.7%), metastatic cancer 6 (11.1%). Univariate analysis revealed significant factors contributing to ineffective drainage in the form of bilirubinemia before stenting (p = 0.028), comorbid cholangitis (p = 0.036), Y-stenting (p = 0.032) and single stenting (p= 0.047). Age, gender and Bismuth classification type were not significant factors affecting ineffective drainage.