TUMOR INVASION TO THE ARTERIES FEEDING THE GALLBLADDER AS A NOVEL RISK FACTOR FOR CHOLECYSTITIS AFTER METALLIC STENT PLACEMENT IN DISTAL MALIGNANT BILIARY OBSTRUCTION

DOI
  • SOGABE Yuko
    Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine. Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • KODAMA Yuzo
    Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine.
  • HONJO Hajime
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • AOYAMA Ikuo
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • MURAMOTO Yuya
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • KOGA Eri
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • YANAIDANI Takafumi
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • KAWAI Munenori
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • YOSHIKAWA Teppei
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • MATSUMOTO Shimpei
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • MATSUMOTO Astushi
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • MORI Yoshiharu
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • ONO Chikage
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • NISHIDA Miyu
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • NISHIDA Yoshihiro
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • MIKAMI Takao
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • MATSUNAGA Yasuhiro
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • MIYAMOTO Yukiko
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • KITAMI Motoya
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • NISHIKAWA Koji
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • KONDO Masahiko
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • MIYAKE Naoki
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • KAWANAMI Chiharu
    Department of Gastroenterology and Hepatology, Otsu Red Cross Hospital.
  • SENO Hiroshi
    Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine.

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Other Title
  • 胆嚢栄養動脈への腫瘍浸潤は遠位部悪性胆道狭窄に対するMetallic Stent留置後胆嚢炎の危険因子である

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Abstract

<p>Background and Aim: Cholecystitis is a major complication after self-expandable metallic stent (SEMS) placement for malignant biliary obstruction. Ischemia is one of the risk factors for cholecystitis, but little is known about the influence of tumor invasion to the feeding artery of the gallbladder on the onset of cholecystitis after SEMS placement. The aim of the present study was to identify risk factors for cholecystitis after SEMS placement. </p><p>Methods: Incidence and nine predictive factors of cholecystitis were retrospectively evaluated in 107 patients who underwent SEMS placement for unresectable distal malignant biliary obstruction at Kyoto University Hospital and Otsu Red Cross Hospital between January 2012 and June 2016.</p><p>Results: Cholecystitis occurred in 13 of 107 patients (12.1%) after SEMS placement during the median follow-up period of 262 days. Univariate analyses showed that tumor invasion to the feeding artery of the gallbladder and tumor involvement to the orifice of the cystic duct were significant predictors of cholecystitis (P＝0.001 and P＜0.001). Multivariate analysis confirmed that these two factors were significant and independent risks for cholecystitis with odds ratios of 22.13 (95% CI, 3.57-137.18; P＝0.001) and 25.26 (95% CI, 4.12-154.98; P＜0.001), respectively.</p><p>Conclusions: This study showed for the first time that tumor invasion to the feeding artery of the gallbladder as well as tumor involvement to the orifice of the cystic duct are independent risk factors for cholecystitis after SEMS placement.</p>

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