Risk factors for ineffective functioning of uncovered biliary stents with high malignant biliary obstruction

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. Stent-ing 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 stent-ing, 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.