Clin Endosc.  2012 Mar;45(1):78-83. 10.5946/ce.2012.45.1.78.

A Comparative Study on the Efficacy of Covered Metal Stent and Plastic Stent in Unresectable Malignant Biliary Obstruction

Affiliations
  • 1Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea. jinhkim@ajou.ac.kr
  • 2Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
  • 3Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
  • 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 5Digestive Disease Center, Bundang CHA Hospital, Korea.
  • 6Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
  • 7Department of Internal Medicine, Asan Medical Center, Seoul, Korea.

Abstract

BACKGROUND/AIMS
The placement of self expandable metal stent (SEMS) is one of the palliative therapeutic options for patients with unresectable malignant biliary obstruction. The aim of this study was to compare the effectiveness of a covered SEMS versus the conventional plastic stent.
METHODS
We retrospectively evaluated 44 patients with unresectable malignant biliary obstruction who were treated with a covered SEMS (21 patients) or a plastic stent (10 Fr, 23 patients). We analyzed the technical success rate, functional success rate, early complications, late complications, stent patency and survival rate.
RESULTS
There was one case in the covered SEMS group that had failed technically, but was corrected successfully using lasso. Functional success rates were 90.5% in the covered SEMS group and 91.3% in the plastic stent group. There was no difference in early complications between the two groups. Median patency of the stent was significantly prolonged in patients who had a covered SEMS (233.6 days) compared with those who had a plastic stent (94.6 days) (p=0.006). During the follow-up period, stent occlusion occurred in 11 patients of the covered SEMS group. Mean survival showed no significant difference between the two groups (covered SEMS group, 236.9 days; plastic stent group, 222.3 days; p=0.182).
CONCLUSIONS
The patency of the covered SEMS was longer than that of the plastic stent and the lasso of the covered SEMS was available for repositioning of the stent.

Keyword

Malignant biliary obstruction; Self-expandable metal stent; Plastic stent
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