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Medientyp:
E-Artikel
Titel:
Stent performance in palliative transhepatic treatment of malignant biliary obstruction
:
a randomized study comparing covered versus uncovered stents
Anmerkungen:
Hinweis: Link zur Erstveröffentlichung URL: https://dx.doi.org/10.1177/0284185120911187
Beschreibung:
Background: Considering the limitations in both uncovered self-expandable metallic stents (USEMS) and covered selfexpandable
metallic stents (CSEMS), it is difficult to make a general recommendation for their application in percutaneous
decompression of malignant biliary obstruction (MBO).
Purpose: To compare percutaneous transhepatic CSEMSs versus USEMSs for the palliative treatment of MBO in terms
of technical success, clinical success, stent patency, patient survival, complications, and stent dysfunction.
Material and Methods: This prospective randomized study included 66 patients with unresectable MBO. CSEMSs
were inserted in 31 patients (26 men, 5 women; mean age¼63.8 7.96 years) and USEMSs were inserted in 35 patients
(26 men, 9 women; mean age¼62.3 11.7 years).
Results: Mean primary stent patency duration was 138 92.7 days in CSEMSs versus 150 77.9 days in USEMSs
(P¼0.578). Tumor overgrowth occurred exclusively in one patient with CSEMS (P¼0.470) and tumor ingrowth exclusively
in two patients with USEMS (P¼0.494). Stent migration occurred in two patients with CSEMSs versus one patient
with USEMSs (P¼0.579). Hemobilia occurred in five patients with CSEMSs versus three patients with USEMSs while bile
leakage occurred in one patient in each group despite the larger introducer sheath caliber with CSEMSs (9 F vs. 6–7 F).
There was no significant difference regarding patient survival (P¼0.969).
Conclusion: In our cohort of patients with rather poor life expectancy, there was no significant difference between
covered and uncovered stents for the palliative treatment of MBO. However, considering the higher cost of CSEMs and
the larger introducer diameter necessary for their placement, USEMSs can be preferred.