Wing-shaped plastic stents vs. self-expandable metal stents for palliative drainage of malignant distal biliary obstruction

• Verfasst von: Schmidt, Arthur [VerfasserIn]
• Verfasst von: Riecken, Bettina [VerfasserIn]
• Verfasst von: Rische, Susanne [VerfasserIn]
• Verfasst von: Klinger, Christoph [VerfasserIn]
• Verfasst von: Jakobs, Ralf [VerfasserIn]
• Verfasst von: Bechtler, Matthias [VerfasserIn]
• Verfasst von: Kähler, Georg [VerfasserIn]
• Verfasst von: Dormann, Arno [VerfasserIn]
• Verfasst von: Caca, Karel [VerfasserIn]
• Titel: Wing-shaped plastic stents vs. self-expandable metal stents for palliative drainage of malignant distal biliary obstruction
• Titelzusatz: a randomized multicenter study
• Verf.angabe: Authors Arthur Schmidt, Bettina Riecken, Susanne Rische, Christoph Klinger, Ralf Jakobs, Matthias Bechtler, Georg Kähler, Arno Dormann, Karel Caca
• E-Jahr: 2015
• Jahr: 15.1.2015
• Umfang: 7 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 11.11.2024
• Titel Quelle: Enthalten in: Endoscopy
• Ort Quelle: Stuttgart [u.a.] : Thieme, 1969
• Jahr Quelle: 2015
• Band/Heft Quelle: 47(2015), 5 vom: Mai, Seite 430-436
• ISSN Quelle: 1438-8812
• DOI: doi:10.1055/s-0034-1391232
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1568050976

Abstract

Background and study aims: Previous studies have shown superior patency rates for self-expandable metal stents (SEMS) compared with plastic stents in patients with malignant biliary obstruction. The aim of this study was to compare stent patency, patient survival, and complication rates between a newly designed, wing-shaped, plastic stent and SEMSs in patients with unresectable, malignant, distal, biliary obstruction. Patients and methods: A randomized, multicenter trial was conducted at four tertiary care centers in Germany. A total of 37 patients underwent randomization between March 2010 and January 2013. Patients underwent endoscopic retrograde cholangiography with insertion of either a wing-shaped, plastic stent without lumen or an SEMS. Results: Stent failure occurred in 10/16 patients (62.5%) in the winged-stent group vs. 4/18 patients (22.2%) in the SEMS group (P=0.034). The median time to stent failure was 51 days (range 2–92 days) for the winged stent and 80 days (range 28–266 days) for the SEMS (P=0.002). Early stent failure (<8 weeks after placement) occurred in 8 patients (50%) vs. 2 patients (11.1%), respectively (P=0.022). After obtaining the results from this interim analysis, the study was discontinued because of safety concerns. Conclusions: The frequency of stent failure was significantly higher in the winged-stent group compared with the SEMS group. A high incidence of early stent failure within 8 weeks was observed in the winged-stent group. Thus, the winged, plastic stent without central lumen may not be appropriate for mid or long term drainage of malignant biliary obstruction.