背景：全覆盖自膨胀金属支架（FCSEMSs）广泛应用于内窥镜治疗远端恶性胆道阻塞（dMBO）。我们旨在评估在dMBO中将外部塑料支架锚定到FCSEMS的疗效。 方法: 在患有dMBO的患者中进行了多中心回顾性队列研究，以比较FCSEMSs和带有外部锚定塑料支架（EPS）的FCSEMSs之间支架通畅的情况。对于外部锚定，首先在胆管中放置7-Fr双猪尾塑料支架（DPPS），然后侧向部署FCSEMS。 结果：在总共185名患者中，65名仅接受FCSEMS治疗，120名接受带EPS的FCSEMS治疗。带有EPS的FCSEMS组中中位支架通畅时间显着长于仅FCSEMS组（342 vs. 240天; P = 0.04）。支架移位率在带有EPS的FCSEMS组中显着低于仅FCSEMS组（10.8％vs.27.7％; P = 0.01）。两组之间在支架阻塞率和不良事件率上无显着差异。 结论：锚定外部塑料支架的新颖简单技术可以减少FCSEMS移位的风险并延长支架通畅时间，在dMBO中不会显着增加不良事件率 – Thieme。版权所有。

BACKGROUND : Fully covered self-expandable metal stents (FCSEMSs) are widely used for endoscopic treatment of distal malignant biliary obstruction (dMBO). We aimed to assess the efficacy of anchoring an external plastic stent to an FCSEMS in dMBO. METHODS : A multicenter retrospective cohort study was performed in patients with dMBO to compare stent patency between FCSEMSs and FCSEMSs with an externally anchored plastic stent (EPS). For external anchoring, a 7-Fr double-pigtail plastic stent (DPPS) was placed first in the bile duct, then an FCSEMS was deployed side-by-side. RESULTS : Among a total of 185 patients, 65 had an FCSEMS alone and 120 had an FCSEMS with an EPS. The median stent patency was significantly longer in the FCSEMS with an EPS group than in the FCSEMS only group (342 vs. 240 days; P = 0.04). The rate of stent migration was significantly lower in the FCSEMS with an EPS group than in the FCSEMS only group (10.8 % vs. 27.7 %; P = 0.01). There were no significant differences in the rates of stent occlusion and adverse events between the two groups. CONCLUSIONS : A novel and simple technique of anchoring an external plastic stent may decrease the risk of FCSEMS migration and prolong stent patency, without significantly increasing the adverse events rate in dMBO.Thieme. All rights reserved.