Differences in efficacy of uncovered self-expandable metal stent in relation to placement in the management of malignant distal biliary obstruction

• Published in: Saudi journal of gastroenterology Vol. 24; no. 2; pp. 82 - 86
• Main Authors: Zhang, Jin-Xing, Zu, Qing-Quan, Liu, Sheng, Zhou, Chun-Gao, Xia, Jin-Guo, Shi, Hai-Bin
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.03.2018; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Aged; Bile Duct Neoplasms - surgery; Biliary tract cancer; Care and treatment; Cholangiopancreatography, Endoscopic Retrograde; Cholestasis - surgery; Distal biliary obstruction; Endoscopy; Female; Humans; Laboratories; Male; Medical imaging; metal stent; Middle Aged; NMR; Nuclear magnetic resonance; Original; outcome; Patient outcomes; Patients; Physiological aspects; Retrospective Studies; Self Expandable Metallic Stents - adverse effects; Society; sphincter of Oddi; Sphincter of Oddi - surgery; Statistical analysis; Stents; Survival Analysis; Saudi Arabia; Distal biliary obstruction; metal stent; outcome; sphincter of Oddi
• ISSN: 1319-3767; 1998-4049; 1998-4049
• DOI: 10.4103/sjg.SJG_326_17

Background/Aims: Metal stent insertion is a common palliative treatment for distal malignant biliary obstruction (MBO) but whether placement across the sphincter of Oddi (SO) causes more complications or shorter survival is in question. The aim of this study was to compare the clinical outcomes of percutaneous uncovered self-expandable metal stent placement above and across the SO in patients with distal MBO. Patients and Methods: We retrospectively studied 59 patients who underwent uncovered metal stent placement for distal MBO between January 2012 and March 2016. Stents were placed above the SO for 22 subjects (group A) and across the SO for 37 subjects (group B). Early cholangitis, stent occlusion, and overall survival time were compared between the two groups. Results: Clinical success was 90.9 and 86.5% for groups A and B, respectively. Early cholangitis occurred in 2 patients (9.1%) in group A and in 6 patients (16.2%) in group B (P = 0.645). Median stent patency and median survival time was 105 and 140 days for group A, 120 and 160 days for group B, respectively. The stent occlusion (31.8% in group A and 21.6% in group B, P = 0.454) and the cumulative stent patency times (P = 0.886) did not differ between the two groups. There was no significant difference in cumulative patient survival between the two groups (P = 0.810). Conclusion: Uncovered metal stent placement across the SO did not significantly affect early cholangitis, stent patency, or patient survival.