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• W1976054023 abstract "Background: Obstruction of the common bile duct is a frequent complication of pancreatic and other malignancies. Metal biliary stents are commonly used to re-establish biliary patency. The efficacy and complications of the two types of metal biliary stents, covered and uncovered, in treating malignant strictures are incompletely defined. Our goal is to compare their performance in a tertiary cancer center. Methods: Patients referred from August 2002 to March 2006 for metal biliary stent placement in strictures involving the common bile duct were studied retrospectively. Only those patients who received their initial metal stent and in whom the proximal aspect of the stent was below the hepatic bifurcation were included. Results: Uncovered metal stents were placed in 112 patients for an average stricture length of 2.7 cm. The underlying malignancy was pancreatic in 74, metastatic colon in 8, duodenal/ampullary in 5 and various others in 25. There were 12 acute complications with pancreatitis in 8, migration in 2, hemobilia and fever in 1 each. The episodes of pancreatitis required an average of 3 days of hospitalization. Stent occlusion was seen in 39 (34.8%) of patients at an average of 140.4 days (SD 131d and median 122d). Of the remaining patients 9 had resection an average of 122.6 days after stent placement and 5 remained alive an average of 241.6 days. The remaining 59 died at a mean of 197.9d after stent placement (median 152.5d). One hundred patients had covered metal stents placed for an average stricture length of 2.4 cm. The underlying malignancy was pancreatic in 78, ampullary in six and other in 16. There were 15 acute complications including pancreatitis (9), persistent fever (3) and migration (2). The episodes of pancreatitis required an average of 4.5 hospital days. Late complications were stent occlusion in 23 and one case of cholecystitis 30 days after stent placement. Stent occlusions occurred at a mean of 245.5 days (SD 149.6, median 201). The remaining patients had Whipple resection (16) on an average of 122.6d, were alive (6) an average of 323 days, or died (58) on average 157.7 days after stent placement. The difference in proportion of occluded stents between groups trended toward statistical significance (p = . 059). The difference in time to occlusion was statistically significant (p = . 05). Differences in rates of pancreatitis and other complications were not statistically significant. Conclusions: Early and late complication rates are comparable between stent types although a trend toward less occlusion with covered stents was noted. The time to occlusion is significantly greater with covered stents." @default.
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• W1976054023 date "2007-04-01" @default.
• W1976054023 modified "2023-09-26" @default.
• W1976054023 title "Performance of Covered vs. Uncovered Metal Stents in Malignant Strictures of the Common Duct" @default.
• W1976054023 doi "https://doi.org/10.1016/j.gie.2007.03.471" @default.
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