Partially Covered Metal Stents May Not Prolong Stent Patency Compared to Uncovered Stents in Unresectable Malignant Distal Biliary Obstruction.
- Author:
Jae Yun KIM
1
;
Gyu Bong KO
;
Tae Hoon LEE
;
Sang Heum PARK
;
Yun Nah LEE
;
Young Sin CHO
;
Yunho JUNG
;
Il Kwun CHUNG
;
Hyun Jong CHOI
;
Sang Woo CHA
;
Jong Ho MOON
;
Young Deok CHO
;
Sun Joo KIM
Author Information
- Publication Type:Original Article
- Keywords: Biliary obstruction; Metal stent; Covered; Uncovered; Patency
- MeSH: Humans; Incidence; Outcome Assessment (Health Care); Retrospective Studies; Stents*
- From:Gut and Liver 2017;11(3):440-446
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Controversy still exists regarding the benefits of covered self-expandable metal stents (SEMSs) compared to uncovered SEMSs. We aimed to compare the patency and stent-related adverse events of partially covered SEMSs (PC-SEMSs) and uncovered SEMSs in unresectable malignant distal biliary obstruction. METHODS: A total of 134 patients who received a PC-SEMS or uncovered SEMS for palliation of unresectable malignant distal biliary obstruction were reviewed retrospectively. The main outcome measures were stent patency, stent-related adverse events, and overall survival. RESULTS: The median stent patency was 118 days (range, 3 to 802 days) with PC-SEMSs and 105 days (range, 2 to 485 days) with uncovered SEMSs (p=0.718). The overall endoscopic revision rate due to stent dysfunction was 36.6% (26/71) with PC-SEMSs and 36.5% (23/63) with uncovered SEMSs (p=0.589). Tumor ingrowth was more frequent with uncovered SEMSs (4.2% vs 19.1%, p=0.013), but migration was more frequent with PC-SEMSs (11.2% vs 1.5%, p=0.04). The incidence of stent-related adverse events was 2.8% (2/71) with PC-SEMSs and 9.5% (6/63) with uncovered SEMSs (p=0.224). The median overall survival was 166 days with PC-SEMSs and 168 days with uncovered SEMSs (p=0.189). CONCLUSIONS: Compared to uncovered SEMSs, PC-SEMSs did not prolong stent patency in unresectable malignant distal biliary obstruction. Stent migration was more frequent with PC-SEMSs. However, tumor ingrowth was less frequent with PC-SEMSs compared to uncovered SEMSs.
