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A prospective randomised trial comparing plastic and uncovered self-expanding metal stents for palliation of symptomatic jaundice in patients with malignant distal biliary obstruction
The aim of this study was to determine the safety and clinical effectiveness of 10Fr plastic biliary stents compared to uncovered self-expanding metal stents (SEMS) for palliative treatment of patients with inoperable malignant distal biliary obstruction in a public hospital in South Africa. Methods...
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| Format: | Thesis |
| Language: | English |
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Division of Surgical Gastroenterology
2017
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| Summary: | The aim of this study was to determine the safety and clinical effectiveness of 10Fr plastic biliary stents compared to uncovered self-expanding metal stents (SEMS) for palliative treatment of patients with inoperable malignant distal biliary obstruction in a public hospital in South Africa. Methods: From January 2009 to December 2013, 40 patients who were admitted to a tertiary academic centre because of distal malignant biliary obstruction were enrolled in a prospective randomised study. Patients were randomly assigned to receive either an uncovered SEMS or a plastic stent deployed through the biliary stricture during endoscopic retrograde cholangiopancreatography. Results: Patient survival time in the two groups did not differ significantly (median: SEMS - 114 days; plastic - 107 days) (p=0.181). Stent failure was more common in the plastic stent group (7/19 vs. 1/20) (p=0.043). The results became significant after 6 months of follow up. There was no significant difference between the two groups in the incidence of serious adverse events. Conclusions: SEMS had a longer duration of patency than plastic stents, which favours their use in the palliative treatment of patients with biliary obstruction due to distal malignant biliary obstruction. |
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