MDBOMultilateral Development Bank Operations
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In most patients with MDBO, the SEMS needs to be placed through the papilla.
We deployed ARMS successfully in all patients initially treated for MDBO. However, as the TRBO in the ARMS group was not significantly different from that in the cCSEMS group (180.0 versus 137.0 days, P = 0.967), we were unable to identify any benefit of ARMS.
This is the first study to have demonstrated that, whereas the antireflux valve significantly reduces food impaction, the stent itself offers no significant advantage for initial stenting of MDBO.
Reintervention is a crucial factor affecting the prognosis of patients with MDBO. In particular, when an ARMS becomes dysfunctional, the antireflux valve has already accumulated much tough sludge.
Therefore, randomized controlled trials comparing ARMS with c-CSEMS with the same underlying structure and materials, except for the antireflux valve, will be needed to determine the most suitable stent for initial treatment of MDBO.
After applying exclusion criteria, 58 patients with MDBO were included in the final analysis.
We adopt an on demand regimen of sten exchange in patients with MDBO to avoid unnecessary procedures and hospital staying.
Despite this knowledge about MPS in benign stenoses, there is only one report of MPS in patients with MDBO, in which two prostheses were applied increasing the permeability time [23].
However, the use of TB <2 mg/dL as the object of evaluation reflects in a practical way the current need that a patient with MDBO has.
The use of SPS was not effective in achieving the total bilirubin levels desired for chemotherapeutic treatment, and there was no statistical difference between the use of MPS, despite the small number of patients compared to the use of SEMS to reach satisfactory levels of bilirubin for the chemotherapeutic treatment, thus determining that the use of both SEMS and MPS can be performed in patients with MDBO.