A randomized trial comparing uncovered and partially covered self-expandable metal stents in the palliation of distal malignant biliary obstruction

Telford, Jennifer J.; Carr‐Locke, David L.; Baron, Todd H.; Poneros, John M.; Bounds, Brenna C.; Kelsey, Peter B.; Schapiro, Robert H.; Huang, Christopher; Lichtenstein, David R.; Jacobson, Brian C.; Saltzman, John R.; Thompson, Christopher C.; Forcione, David G.; Gostout, Christopher J.; Brugge, William R.

doi:10.1016/j.gie.2010.08.021

Cited by 230 publications

(190 citation statements)

References 18 publications

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“…It is important to consider that obstruction resolution depends on the stent remaining in place, which depends on the type of stent used. Totally covered SEMS appear to migrate more frequently (3%-12%) compared to uncovered SEMS (< 1%) (11)(12)(13)(14). In our series, migration occurred in 9.1% (n = 2) of those with covered SEMS, although this was not statistically significant (p = 0.101).…”

Section: Discussioncontrasting

confidence: 71%

“…This result depends on several circumstances since partially covered SEMS can also become occluded as a result of tumor growth or granulation tissue through the spaces in the stent's ends in 12% to 14% of cases (3,11,12). In our groups, clinical success according to the protocol of covered and uncovered SEMS was 95.5% and 87%, respectively, and there was no statistically significant difference in terms of biochemical parameter decreases.…”

Section: Discussionmentioning

confidence: 61%

“…Partially covered SEMS became occluded in 14% of cases, after a mean follow-up of 304 days compared to 38% of the uncovered SEMS, after a mean follow-up of 166 days (p = 0.0032) (3). Furthermore, Telford et al reported a 12% migration rate with the use of partially covered SEMS, a percentage similar to that obtained with the use of plastic stents (5-10%) (1,11). This number is acceptable if, in return, permeability is prolonged.…”

Section: Discussionmentioning

confidence: 76%

“…Two clinical trials did not detect a difference when comparing totally covered SEMS with uncovered SEMS (11,16). This is perhaps due to the fact that most patients with pancreatobiliary tumors are first evaluated in advanced stages of the disease and die within the first 6 months of palliation without evidence of stent dysfunction; it is, thus, difficult to establish a difference when comparing both types of stents.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of covered and uncovered self-expandable stents in the treatment of malignant biliary obstruction

Carmona¹,

Lárraga²,

Guerrero³

et al. 2016

Rev Esp Enferm Dig

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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.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Comparison of covered and uncovered self-expandable stents in the treatment of malignant biliary obstruction

Carmona¹,

Lárraga²,

Guerrero³

et al. 2016

Rev Esp Enferm Dig

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“…6 However, whether uncovered or covered SEMS have superior stent patency period remains controversial. [7][8][9][10] One of the reasons for this may be because of differences between covering materials in membrane biodurability under long-term exposure to bile juice. 11 The reason that the stent patency period was shorter and the patency rate was lower than expected in some clinical studies of covered SEMS may be due to cracks in the covering membrane with subsequent tumor ingrowth (Fig.…”

Section: Covering Membranementioning

confidence: 99%

Spontaneous Common Bile Duct Perforation Treated with Placement of Metal Stent

Yang¹,

Moon²,

You³

et al. 2016

Korean J Pancreas Biliary Tract

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Biliary self-expandable metal stents (SEMS), a group of non-vascular stents, have been used in the palliative management of biliary obstruction around the world. However, there are still unmet needs in the clinical application of biliary SEMS. Comprehensive understanding of the SEMS is required to resolve the drawbacks and difficulties of metal stent development. The basic structure of SEMS, including the materials and knitting methods of metal wires, covering materials, and radiopaque markers, are discussed in this review. What we know about the physical and mechanical properties of the SEMS is very important. With an understanding of the basic knowledge of metal stents, hurdles such as stent occlusion, migration, and kinking can be overcome to develop more ideal SEMS.

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The Role of ERCP in Pancreatico‐Biliary Malignancies

Parasher¹,

Lee²

2005

Advanced Digestive Endoscopy: ERCP

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A randomized trial comparing uncovered and partially covered self-expandable metal stents in the palliation of distal malignant biliary obstruction

Cited by 230 publications

References 18 publications

Comparison of covered and uncovered self-expandable stents in the treatment of malignant biliary obstruction

Comparison of covered and uncovered self-expandable stents in the treatment of malignant biliary obstruction

Spontaneous Common Bile Duct Perforation Treated with Placement of Metal Stent

The Role of ERCP in Pancreatico‐Biliary Malignancies

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