Year 2016 / Volume 108 / Number 5
Original
Comparison of covered and uncovered self-expandable stents in the treatment of malignant biliary obstruction

246-249

DOI: 10.17235/reed.2016.4161/2015

Diana Yamel Flores Carmona, Juan Octavio Alonso Lárraga, Angélica Hernández Guerrero, Mauro Eduardo Ramírez Solís,

Abstract
Background and objective: Drainage with metallic stents is the treatment of choice in malignant obstructive jaundice. Technical and clinical success with metallic stents is obtained in over 90% and 80% of cases, respectively. There are self-expandable metallic stents designed to increase permeability. The aim of this study was to describe the results obtained with totally covered self-expandable and uncovered self-expandable metallic stents in the palliative treatment of malignant biliary obstruction. Patients and methods: Sixty eight patients with malignant obstructive jaundice secondary to pancreatobiliary or metastatic disease not amenable to surgery were retrospectively included. Two groups were created: group A (covered self-expandable metallic stents) (n = 22) and group B (uncovered self-expandable metallic stents) (n = 46). Results: Serum total bilirubin, direct bilirubin, alkaline phosphatase and gamma glutamyl transferase levels decreased in both groups and no statistically significant difference was detected (p = 0.800, p = 0.190, p = 0.743, p = 0.521). Migration was greater with covered stents but it was not statistically significant either (p = 0.101). Obstruction was greater in the group with uncovered stents but it was not statistically significant either (p = 0.476). Conclusion: There are no differences when using covered self-expandable stents or uncovered self-expandable stents in terms of technical and clinical success or complications in the palliative treatment of malignant obstructive jaundice.
Share Button
New comment
Comments
No comments for this article
References
1. Dumonceau JM, Tringali A, Blero D, et al. Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy 2012;44:277-98
2. Shah RJ, Howell DA, Desilets DJ, et al. Multicenter randomized trial of the spiral Z-stent compared with the Wallstent for malignant biliary obstruction. Gastrointest Endosc 2003; 57:830-6
3. Isayama H, Komatsu Y, Tsujino T, et al. A prospective randomised study of covered versus uncovered diamond stents for the management of distal malignant biliary obstruction. Gut 2004;53:729-34
4. Petersen BT, Kahaleh M, Kozarek RA, et al., “A Multicenter, Prospective Study of a New Fully Covered Expandable Metal Biliary Stent for the Palliative Treatment of Malignant Bile Duct Obstruction” Gastroenterol Res Pract. 2013;2013:642428.
5. Andersen JR, Sorensen SM, Kruse A, et al. “Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice” Gut 1989; 30:1132–5.
6. Artifon E, Sakai P, Cunha J, et al. “Surgery or endoscopy for palliation of biliary obstruction due to metastatic pancreatic cancer” Am J of Gastroenterol 2006; 101: 2031–7.
7. Speer AG, Cotton PB, Russell RCG. Randomized trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice” Lancet 1987; 2: 57–62.
8. Kaasis M, Boyer J, Dumas R, et al. Plastic or metal stents for malignant stricture of the common bile duct? Results of a randomized prospective study. Gastrointest Endosc 2003; 57:178-82
9. Soderlund C, Linder S. Covered versus plastic stents for malignant common bile duct stenosis: a prospective,randomized, controlled trial. Gastrointest Endosc 2006; 63:986-95
10. Weston B, Ross WA, Liu J, et al. Clinical outcomes of nitinol and stainless steel uncovered metal stents for malignant biliary strictures: is there a difference? Gastrointest Endosc 2010; 72:1195-200
11. Telford J, Carr-Locke D, Baron T, et al. A randomized trial comparing uncovered and partially covered self-expandable metal stents in the palliation of distal biliary obstruction. Gastrointest Endosc 2010;72:907-14
12. Kahaleh M, Tokar J, Conaway JMR, et al. “Efficacy and complications of covered Wallstents in malignant distal biliary obstruction” Gastrointest Endosc 2005; 61:528–33
13. Kullman E, Frozanpor R, Söderlund C, et al. Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: result from a randomized, multicenter study. Gastrointest Endosc 2010; 72:915-23.
14. Yang KY, Ryu JK, Seo JK, et al. A comparison of the Niti-D biliary uncovered stent and the uncovered Wallstent in malignant biliary obstruction. Gastrointest Endosc 2009;70:45-51.
15. Bakhru M, Ho HC, Gohil V, et al. Fully-covered, self-expandable metal stents (CSEMS) in malignant distal biliary strictures: Mid-term evaluation. J Gastroenterol Hepatol 2011;26:1022-27
16. Kullman E, Frozanpor F, Söderlund C, et al. Covered versus Uncovered self-expandable nitinol stents in the palliative treatment of malignant biliary obstruction: results from a randomized, multicenter study. Gastrointest Endosc 2010; 72:915-23
17. Saleem A, Leggett CL, Murad MH, et al. Meta-analysis of randomized trials comparing the patency of covered and uncovered self-expandable metal stents for palliation of distal malignant bile duct obstruction. Gastrointest Endosc 2011; 74:321-27
18. Domper Arnal MJ, Simón Marco MA. Endoscopic management of malignant biliary stenosis. Update and highlights for standard clinical practice . Rev Esp Enferm Dig. 2016 Jan 20.
Citation tools
Flores Carmona D, Alonso Lárraga J, Hernández Guerrero A, Ramírez Solís M. Comparison of covered and uncovered self-expandable stents in the treatment of malignant biliary obstruction. 4161/2015


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 908 visits.
This article has been downloaded 119 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 14/12/2015

Accepted: 12/02/2016

Online First: 21/03/2016

Published: 29/04/2016

Article revision time: 56 days

Article Online First time: 98 days

Article editing time: 137 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology