Publications (2)3.32 Total impact
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Article: Bilateral biliary drainage for malignant hilar obstruction using the 'stent-in-stent' method with a Y-stent: efficacy and complications.
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ABSTRACT: BACKGROUND: The usefulness of bilateral stent placement for malignant hilar obstruction is still under debate. Nevertheless, many endoscopists advocate the placement of an endoscopic bilateral metal stent using various new devices and techniques. OBJECTIVES: We compared the technical and clinical efficacy, and the short-term and long-term complications of the 'stent-in-stent' method using a Y-stent for malignant hilar obstruction between the early and the late period of this study. MATERIALS AND METHODS: Ninety-seven patients treated with Y-stent implantation for malignant hilar obstruction were enrolled retrospectively. In 31 patients treated during the early period, bilateral Y-configured metal stents were placed for malignant hilar obstruction using the older designed Y-stent and a closed-cell second stent. The newly designed Y-stent and a slimmer open-cell second stent were introduced in 66 patients treated during the late period. New techniques learned through experience were gradually applied throughout the entire study period. RESULTS: The rate of successful placement of bilateral stents was significantly higher in patients treated during the late period than those treated during the early period (58.1 vs. 87%; P=0.001). The functional success rate was 97.3%, with no difference between the early and the late periods. Cholangitis occurred as an early complication more frequently during the early period than during the late period (16.1 vs. 1.5%; P=0.012). Cholecystitis as a late complication occurred in 21 of 76 patients (27.6%). The incidence of late complications was similar between the early and the late periods. CONCLUSION: With the development of new devices and increased technical experience, there were better outcomes during the late period compared with the early period. Endoscopic bilateral metal stenting using a Y-stent is an attractive option for the palliative treatment of malignant hilar obstruction.European journal of gastroenterology & hepatology 09/2012; · 1.66 Impact Factor -
Article: Venous thromboembolism in patients with cholangiocarcinoma: focus on risk factors and impact on survival.
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ABSTRACT: A high incidence of venous thromboembolism (VTE) has been observed in patients with cancer. However, few data are available on patients with cholangiocarcinoma. The aim of this study was to evaluate the clinical characteristics and risk factors of VTE and to investigate whether VTE would affect the survival of patients with cholangiocarcinoma. We retrospectively reviewed 273 patients who were diagnosed with cholangiocarcinoma from January 2004 to December 2008. We observed 40 cases of VTE, among which 10 patients had VTE at diagnosis. There were 14 cases of pulmonary thromboembolism with or without deep vein thrombosis, 18 cases of portal vein thrombosis, four cases of inferior vena cava thrombosis, and four of hepatic vein thrombosis. We found that progression of stage, C-reactive protein, and chemotherapy were significantly associated with the occurrence of VTE (P=0.022, 0.006, and 0.014, respectively). The median survival in the VTE and non-VTE groups were 13.0 and 25.0 months, respectively (log-rank test, P=0.026). VTE was an unfavorable prognostic factor for cholangiocarcinoma (hazard ratio=1.626, P=0.042). In our study, advanced stage, C-reactive protein, and treatment with chemotherapeutic agents were related to the occurrence of VTE in patients with cholangiocarcinoma. VTE was an independent unfavorable prognostic factor for survivors of cholangiocarcinoma.European journal of gastroenterology & hepatology 04/2012; 24(4):444-9. · 1.66 Impact Factor
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2012
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Pusan National University
Pusan, Busan, South Korea
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