Background and Objectives In transpapillary biliary drainage, metal stents (MSs) exhibit a lower incidence of a biliary obstruction than plastic stents (PSs). However, few studies have compared recurrent biliary obstruction (RBO) when MSs and PSs are used in EUS-guided hepaticogastrostomy (EUS-HGS) and choledochoduodenostomy (EUS-CDS). We retrospectively evaluated the RBO for both stents in each procedure. Patients and Methods : Between November 2012 and December 2020, 85 and 53 patients who underwent EUS-HGS and EUS-CDS for unresectable malignant biliary obstruction, respectively, were enrolled. Factors associated with RBO were assessed. Clinical outcomes were compared between the MS and PS groups using propensity score matching. Results : The clinical success rate and procedure-related adverse events were similar in the MS and PS groups. Multivariate analysis identified the use of PS as a factor associated with RBO (EUS-HGS, P = 0.03; EUS-CDS, P = 0.02). After matching, the median time to RBO in EUS-HGS (MS: 313; PS: 125 days; P = 0.01) in the MS group was longer than that in the PS group. The cumulative incidence of RBO at 1, 3, and 6 months in the MS group was significantly lower than that in the PS group for EUS-HGS (MS: 4.0%, 8.2%, and 8.2%; PS: 12.4%, 24.9%, and 39.5%, respectively, P = 0.01). Conclusions : MS exhibited a lower rate of RBO than PS for EUS-HGS and EUS-CDS.

中文翻译：

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在 EUS 引导的胆道引流中使用金属和塑料支架复发性胆道梗阻的比较：倾向评分匹配分析。

背景和目的 在经乳头胆道引流中，金属支架 (MS) 的胆道梗阻发生率低于塑料支架 (PS)。然而，当 MS 和 PS 用于 EUS 引导的肝胃吻合术 (EUS-HGS) 和胆总管十二指肠吻合术 (EUS-CDS) 时，很少有研究比较复发性胆道梗阻 (RBO)。我们回顾性地评估了每个手术中两个支架的 RBO。患者和方法：2012 年 11 月至 2020 年 12 月期间，分别招募了 85 名和 53 名因无法切除的恶性胆道梗阻而接受 EUS-HGS 和 EUS-CDS 的患者。评估了与 RBO 相关的因素。使用倾向评分匹配在 MS 和 PS 组之间比较临床结果。结果：MS 和 PS 组的临床成功率和手术相关不良事件相似。多变量分析将 PS 的使用确定为与 RBO 相关的一个因素（EUS-HGS，P = 0.03；EUS-CDS，P = 0.02）。匹配后，MS 组 EUS-HGS 中至 RBO 的中位时间（MS：313；PS：125 天；P = 0.01）比 PS 组长。EUS-HGS MS组1、3、6个月RBO累积发生率明显低于PS组（MS：4.0%、8.2%、8.2%；PS：12.4%、24.9%）和 39.5%，P = 0.01)。结论：对于 EUS-HGS 和 EUS-CDS，MS 的 RBO 率低于 PS。MS组和6个月EUS-HGS显着低于PS组（MS：4.0%、8.2%和8.2%；PS：分别为12.4%、24.9%和39.5%，P=0.01 ). 结论：对于 EUS-HGS 和 EUS-CDS，MS 的 RBO 率低于 PS。MS组和6个月EUS-HGS显着低于PS组（MS：4.0%、8.2%和8.2%；PS：分别为12.4%、24.9%和39.5%，P=0.01 ). 结论：对于 EUS-HGS 和 EUS-CDS，MS 的 RBO 率低于 PS。