Partially Covered Metal Stents May Not Prolong Stent Patency Compared to Uncovered Stents in Unresectable Malignant Distal Biliary Obstruction
- 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.
- All Author(s)
- J. Y. Kim
; G. B. Ko
; T. H. Lee
; S. H. Park
; Y. N. Lee
; Y. S. Cho
; Y. Jung
; I. K. Chung
; H. J. Choi
; S. W. Cha
; J. H. Moon
; Y. D. Cho
; S. J. Kim
- Issued Date
- 2017
- Type
- Article
- Keyword
- Biliary obstruction; Metal stent; Covered; Uncovered; Patency
- Publisher
- 대한소화기학회
- ISSN
- 1976-2283
- Citation Title
- Gut and Liver
- Citation Volume
- 11
- Citation Number
- 3
- Citation Start Page
- 440
- Citation End Page
- 446
- Language(ISO)
- eng
- DOI
- 10.5009/gnl16245
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2978
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