Comparison of fully covered self-expanding metal stents and multiple plastic stents for benign biliary strictures
10.3760/cma.j.cn321463-20210308-00905
- VernacularTitle:全覆膜自膨式金属支架和多根塑料支架治疗良性胆管狭窄的对比研究
- Author:
Yishen MAO
1
;
Hui JIA
;
Hongzhang SHEN
;
Lei LU
;
Xiaofeng ZHANG
Author Information
1. 杭州市第一人民医院消化内科，杭州310000
- Keywords:
Stents;
Biliary diseases;
Cholangiopancreatography, endoscopic retrograde;
Fully covered self-expanding metal stent;
Plastic stent
- From:
Chinese Journal of Digestive Endoscopy
2022;39(3):192-197
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the fully covered self-expanding metal stents (FCSEMS) and multiple plastic stents (MPS) in the effectiveness, safety and cost-effectiveness for benign bile duct strictures.Methods:A single-center retrospective study was conducted to analyze the clinical data of 107 patients with benign biliary strictures who underwent FCSEMS or MPS implantation through endoscopic retrograde cholangiopancreatography (ERCP) in Hangzhou First People's Hospital from January 2013 to June 2019.There were 54 cases in group FCSEMS and 53 cases in group MPS. Benign biliary stricture was confirmed by computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography. The primary index was the rate of stricture remission, and the secondary indices were the incidence of stricture recurrence, ERCP-related complications, the rate of stent migration, hospital stay and charges.Results:The median follow-up times were 10.0 (6.5, 18.0) months and 12.0 (9.0, 20.0) months in group FCSEMS and in group MPS respectively ( P>0.05). The rates of stricture remission in the two groups were 87.0% (47/54) and 83.0% (44/53), the incidences of stricture recurrence were 14.6% (6/41) and 23.5% (8/34), and the incidences of ERCP-related complications were 14.8% (8/54) and 11.9% (13/109), respectively. And the differences were not statistically significant (all P>0.05). But the stent migration rates of the two groups were 22.9% (11/54) and 2.8% (3/109) with significant difference ( P<0.001). Cost-effectiveness analysis showed that the median numbers of ERCP intervention in the two groups were 2 (2,2) times and 3 (2,4) times ( P<0.001), and the median hospital stays were 6.0 (4.0,11.0) days and 9.0 (6.5,16.0) days respectively ( P=0.009). The median hospitalization expenses of the two groups were 44 646 yuan and 51 355 yuan without significant difference ( P>0.05). Conclusion:The effectiveness, safety and cost of FCSEMS for benign bile duct stenosis are similar to those of MPS, but it reduces ERCP intervention and treatment cycles. Even with a certain migration rate, it can still be a first-line treatment approach.
