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Should plastic stents be avoided in all unresectable malignant perihilar biliary strictures?
Author(s) -
Kawashima Hiroki,
Itoh Akihiro,
Ohno Eizaburo,
Goto Hidemi,
Hirooka Yoshiki
Publication year - 2013
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12088
Subject(s) - medicine , stent , biliary drainage , retrospective cohort study , surgery , bile duct , radiology , endoscopy , confidence interval , single center
Clinical guidelines of the E uropean S ociety of G astrointestinal E ndoscopy recommend the insertion of self‐expandable metallic stents ( SEMS ) as opposed to plastic stents ( PS ) in patients with unresectable malignant perihilar stricture ( MHS ). However, PS are cheaper and easier to insert into the biliary duct compared to SEMS . Furthermore, PS are removable and easy to move into subsequent drainage procedures. We conducted the present retrospective single‐center study to elucidate the predictive factors associated with stent patency period duration in patients with unresectable MHS who would benefit from a long patency period after PS placement. This study included 56 consecutive patients with unresectable MHS who were drained using PS . PS failure occurred in 26 (46.4%) patients. The median patency period was72 days (95% confidence interval: 29.8–114). The only significant predictive factor associated with the length of the stent patency period was history of previous endoscopic sphincterotomy ( EST ). Median patency periods with and without previous EST were 28 and 109 days, respectively ( P = 0.016). In conclusion, we suggest that conventional biliary drainage with PS is still a suitable option for the treatment of unresectable MHS in patients without previous EST .