Treatment of malignant biliary obstruction by percutaneous transhepatic insertion of expandable metallic stents

1995 ◽  
Vol 5 (1) ◽  
Author(s):  
P.H. Hannesson ◽  
�. Andr�n-Sandberg ◽  
H. Stridbeck ◽  
W. Cwikiel
Keyword(s):  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Metallic Stents ◽  
Expandable Metallic Stents

Malignant biliary obstruction: treatment with self-expandable metallic stents

1995 ◽  
Vol 5 (1) ◽  
Author(s):  
T. Cumhur ◽  
M.N. �smen ◽  
O. Akhan ◽  
T. �l�er ◽  
S. �ekirge ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Metallic Stents ◽  
Expandable Metallic Stents

Self-Expandable Metallic Stents for Malignant Biliary Obstruction with Anomalous Pancreaticobiliary Junction

2007 ◽  
Vol 65 (5) ◽  
pp. AB234
Author(s):  
Hirofumi Kogure ◽  
Hiroyuki Isayama ◽  
Hiroshi Yagioka ◽  
Takashi Sasaki ◽  
Yousuke Nakai ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Metallic Stents ◽  
Anomalous Pancreaticobiliary Junction ◽  
Expandable Metallic Stents

Stent performance in palliative transhepatic treatment of malignant biliary obstruction: a randomized study comparing covered versus uncovered stents

2020 ◽  
Vol 61 (12) ◽  
pp. 1591-1599
Author(s):  
Aboelyazid Elkilany ◽  
Mohamed Alwarraky ◽  
Dominik Geisel ◽  
Mohamed A Maaly ◽  
Timm Denecke
Keyword(s):  
Biliary Obstruction ◽  
Palliative Treatment ◽  
Patient Survival ◽  
Randomized Study ◽  
Malignant Biliary Obstruction ◽  
Metallic Stents ◽  
Stent Patency ◽  
Uncovered Stents ◽  
Significant Difference ◽  
Expandable Metallic Stents

Background Considering the limitations in both uncovered self-expandable metallic stents (USEMS) and covered self-expandable 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 age = 63.8 ± 7.96 years) and USEMSs were inserted in 35 patients (26 men, 9 women; mean age = 62.3 ± 11.7 years). Results Mean primary stent patency duration was 138 ± 92.7 days in CSEMSs versus 150 ± 77.9 days in USEMSs ( P = 0.578). Tumor overgrowth occurred exclusively in one patient with CSEMS ( P = 0.470) and tumor ingrowth exclusively in two patients with USEMS ( P = 0.494). Stent migration occurred in two patients with CSEMSs versus one patient with USEMSs ( P = 0.579). 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 ( P = 0.969). 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.

Covered and Uncovered Self-Expandable Metallic Stents in the Treatment of Malignant Biliary Obstruction

2020 ◽  
Vol 22 (7) ◽  
Author(s):  
Lian-Biao Li ◽  
Wen-Yan Qin ◽  
Wen-Ping Peng ◽  
Jin-Zhen Li ◽  
Ming-Ming Zhang ◽  
...  
Keyword(s):  
Biliary Obstruction ◽  
Meta Analysis ◽  
Malignant Biliary Obstruction ◽  
Metallic Stents ◽  
Metal Stents ◽  
Stent Patency ◽  
Advantages And Disadvantages ◽  
Study Results ◽  
Significant Difference ◽  
Expandable Metallic Stents

Context: Self-expandable metal stents (SEMSs) are commonly used in the treatment of malignant biliary obstruction. We performed a meta-analysis to compare the efficacy of covered self-expandable metallic stents (CSEMSs) and uncovered self-expandable metallic stents (UCSEMSs) for patients with malignant distal biliary obstruction. Methods: A comprehensive search was conducted using PubMed, Embase, Cochrane, and CNKI databases from 2010 to 2019. All randomized controlled trials, which compared the use of the CSEMSs and UCSEMSs for the treatment of malignant distal biliary obstruction were included in this study. Results: This meta-analysis included 1,539 patients enrolled in 13 trials. There was no difference between the two groups in terms of patients’ survival (hazard ratio (HR) 0.96, 95% confidence interval (CI): 0.87 - 1.07; I2 = 32.6%), stent patency (HR 0.92, 95% CI: 0.69 - 1.22; I2 = 56.3%), and the overall complication rate (relative risks (RR) 1.35, 95% CI: 0.82 - 2.23; I2 = 0%). In particular, the CSEMSs group presented a lower rate of tumor ingrowth (RR 0.30, 95% CI: 0.15 - 0.57; I2 = 58.5%) than the UCSEMSs group. However, the CSEMSs group exhibited a higher rate of tumor overgrowth (RR 1.63, 95% CI: 1.00 - 2.66; I2 = 0%), sludge formation (RR 2.28, 95% CI: 1.36 - 3.82; I2 = 0%), and migration (RR 5.14, 95% CI: 1.90 - 13.88; I2 = 0%). Conclusions: Our meta-analysis indicated that there was no significant difference between the two stents, and each one had its advantages and disadvantages.

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