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Objective <p>Endoscopic bilioduodenal double stenting is sometimes necessary for patients with malignant bilioduodenal obstruction (MBDO). The patency of biliary stents is important for preventing cholangitis and continuing treatment. However, the factors that influence recurrent biliary obstruction (RBO) in patients with MBDO are not well known. This study aimed to identify the factors associated with RBO in patients who underwent endoscopic bilioduodenal double stenting.</p> Methods <p>Patient characteristics, device use, and endoscopic treatment procedures were evaluated as possible risk factors for RBO.</p> Results <p>Overall, 55 patients with MBDO underwent endoscopic bilioduodenal double stenting (transpapillary drainage, <i>n</i> = 35; endoscopic ultrasound-guided biliary drainage, <i>n</i> = 20). Multivariate analysis using a Fine and Gray competing risk model revealed that biliary stenting on the oral side of the duodenal stricture (HR 2.98; 95% CI 1.16–7.68; <i>p</i> = 0.023) and chemotherapy (HR 3.74; 95% CI 1.25–11.22; <i>p</i> = 0.018) were significantly associated with RBO.</p> Conclusion <p>Biliary stenting on the oral side of the duodenal stricture was associated with RBO during duodenal stenting in patients with MBDO. Although chemotherapy was also associated with RBO in the multivariable competing risk analysis, this finding should be interpreted cautiously. Careful treatment selection, including consideration of gastrojejunostomy in patients with oral-side biliary stenting, may help reduce the incidence of RBO.</p>

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Risk Factors Associated with Recurrent Biliary Obstruction After Endoscopic Bilioduodenal Double Stenting

  • 期刊论文

  • 发表日期：

    2026年7月8日

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  • Mitsuru Sugimoto,
  • Tadayuki Takagi,
  • Rei Suzuki,
  • Hiroyuki Asama,
  • Hiroshi Shimizu,
  • Kentaro Sato,
  • Kento Osawa,
  • Rei Ohira,
  • Jun Nakamura,
  • Tsunetaka Kato,
  • Takumi Yanagita,
  • Mitsuru Otsuka,
  • Takuto Hikichi,
  • Hiromasa Ohira

摘要

Objective

Endoscopic bilioduodenal double stenting is sometimes necessary for patients with malignant bilioduodenal obstruction (MBDO). The patency of biliary stents is important for preventing cholangitis and continuing treatment. However, the factors that influence recurrent biliary obstruction (RBO) in patients with MBDO are not well known. This study aimed to identify the factors associated with RBO in patients who underwent endoscopic bilioduodenal double stenting.

Methods

Patient characteristics, device use, and endoscopic treatment procedures were evaluated as possible risk factors for RBO.

Results

Overall, 55 patients with MBDO underwent endoscopic bilioduodenal double stenting (transpapillary drainage, n = 35; endoscopic ultrasound-guided biliary drainage, n = 20). Multivariate analysis using a Fine and Gray competing risk model revealed that biliary stenting on the oral side of the duodenal stricture (HR 2.98; 95% CI 1.16–7.68; p = 0.023) and chemotherapy (HR 3.74; 95% CI 1.25–11.22; p = 0.018) were significantly associated with RBO.

Conclusion

Biliary stenting on the oral side of the duodenal stricture was associated with RBO during duodenal stenting in patients with MBDO. Although chemotherapy was also associated with RBO in the multivariable competing risk analysis, this finding should be interpreted cautiously. Careful treatment selection, including consideration of gastrojejunostomy in patients with oral-side biliary stenting, may help reduce the incidence of RBO.