Segment-Specific Occlusion of Retrieved Plastic Biliary Stents: Direct Quantification and Microbial and Material Determinants.
- 1Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama Prefecture, Japan.
- 2Center for Innovative Clinical Medicine, Medical Development Field, Okayama University, Okayama, Okayama Prefecture, Japan.
Abstract
Objectives
Plastic stents (PS) are widely used for biliary drainage, with occlusion mainly caused by biofilm formation and sludge accumulation. However, direct evaluation of luminal occlusion remains limited, and its spatial distribution is poorly understood. This study aimed to quantify luminal occlusion in retrieved PS and identify associated factors.Methods
In this prospective observational study, 64 patients (196 stents) undergoing scheduled PS exchange at approximately 3-month intervals were included. Retrieved stents were divided into proximal, central, and distal segments, and occlusion was quantified using ImageJ. Clinical, microbiological, and device-related variables were analyzed. Multivariable linear regression was used to identify independent factors associated with occlusion.Results
The mean occlusion rate was 28.8% ± 29.8%. Occlusion was significantly higher in the proximal segment than in the central and distal segments (35.5% vs. 25.8% and 25.0%; p < 0.05). Multivariable analysis showed that age > 65 years (β = 11.62, p = 0.006), Enterococcus-positive bile culture (β = 16.00, p = 0.012), and probiotic use (β = 14.91, p = 0.007) were independently associated with increased occlusion. Stent brand was also associated with the degree of occlusion.Conclusions
Plastic stent occlusion is segment-dependent, predominantly affecting the proximal portion, and is associated with microbiological and material-related factors. Direct quantification may help optimize stent design and management.
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BibTeX
@article{matsumi2026segmentspecific,
title = {{Segment-Specific Occlusion of Retrieved Plastic Biliary Stents: Direct Quantification and Microbial and Material Determinants.}},
author = {Akihiro Matsumi and Kazuyuki Matsumoto and Kentaro Oki and Satoshi Kajitani and Ryosuke Sato and Tatsuya Kikuchi and Kazuya Miyamoto and Hiroyuki Terasawa and Yuki Fujii and Daisuke Uchida and Shigeru Horiguchi and Koichiro Tsutsumi and Toshiharu Mitsuhashi and Motoyuki Otsuka},
journal = {Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society},
year = {2026},
month = nov,
doi = {10.1111/den.70324},
url = {https://europepmc.org/article/MED/42973166},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Segment-Specific Occlusion of Retrieved Plastic Biliary Stents: Direct Quantification and Microbial and Material Determinants.
AU - Akihiro Matsumi
AU - Kazuyuki Matsumoto
AU - Kentaro Oki
AU - Satoshi Kajitani
AU - Ryosuke Sato
AU - Tatsuya Kikuchi
AU - Kazuya Miyamoto
AU - Hiroyuki Terasawa
AU - Yuki Fujii
AU - Daisuke Uchida
AU - Shigeru Horiguchi
AU - Koichiro Tsutsumi
AU - Toshiharu Mitsuhashi
AU - Motoyuki Otsuka
PY - 2026
DA - 2026/11/01
JO - Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
DO - 10.1111/den.70324
UR - https://europepmc.org/article/MED/42973166
AB - Objectives Plastic stents (PS) are widely used for biliary drainage, with occlusion mainly caused by biofilm formation and sludge accumulation. However, direct evaluation of luminal occlusion remains limited, and its spatial distribution is poorly understood. This study aimed to quantify luminal occlusion in retrieved PS and identify associated factors.Methods In this prospective observational study, 64 patients (196 stents) undergoing scheduled PS exchange at approximately 3-month intervals were included. Retrieved stents were divided into proximal, central, and distal segments, and occlusion was quantified using ImageJ. Clinical, microbiological, and device-related variables were analyzed. Multivariable linear regression was used to identify independent factors associated with occlusion.Results The mean occlusion rate was 28.8% ± 29.8%. Occlusion was significantly higher in the proximal segment than in the central and distal segments (35.5% vs. 25.8% and 25.0%; p < 0.05). Multivariable analysis showed that age > 65 years (β = 11.62, p = 0.006), Enterococcus-positive bile culture (β = 16.00, p = 0.012), and probiotic use (β = 14.91, p = 0.007) were independently associated with increased occlusion. Stent brand was also associated with the degree of occlusion.Conclusions Plastic stent occlusion is segment-dependent, predominantly affecting the proximal portion, and is associated with microbiological and material-related factors. Direct quantification may help optimize stent design and management.
SN - 0915-5635
SN - 1443-1661
ER -