Side-by-side placement of fully covered metal stents versus conventional 7F plastic stents in malignant hilar biliary obstruction: Prospective randomized controlled trial

Woo Hyun Paik, Min Kyu Jung, Dong Uk Kim, Tae Jun Song, Min Jae Yang, Young Hoon Choi, Joo Seong Kim, Min Woo Lee, Jin Ho Choi, Sang Hyub Lee

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objectives: We aimed to evaluate the efficacy and safety of metal stents compared with plastic stents when bilateral side-by-side stents were deployed for malignant hilar biliary obstruction (MHBO). Methods: Fifty patients with unresectable advanced MHBO were randomly assigned to the metal stent (MS, n = 25) or plastic stent group (PS, n = 25). Fully covered self-expandable metal stents with 6 mm diameter and plastic stents with either 7F straight or double pigtail were used for MS and PS groups, respectively. Time to recurrent biliary obstruction (TRBO) was evaluated as the primary outcome. Results: Both groups had 100% technical success rates; 88% and 76% of clinical success rates were obtained in MS and PS, respectively. Although stent migrations were more frequent in MS than PS (48% vs. 16%, P = 0.02), the mean TRBO was significantly longer in MS (190 days; 95% confidence interval [CI] 121–260 days vs. 96 days; 95% CI 50–141 days, P = 0.02). The placement of plastic stents (hazard ratio 2.42; 95% CI 1.24–4.73; P = 0.01) was the only significant risk factor associated with TRBO in multivariable analysis. The rates of adverse events were similar between the two groups (difference 0%; 95% CI −25% to 25%; P > 0.99). Conclusions: During bilateral side-by-side deployment in MHBO, the use of metal stents appears to be preferable to plastic stents in terms of TRBO, despite a higher frequency of stent migration.

Original languageEnglish
Pages (from-to)473-480
Number of pages8
JournalDigestive Endoscopy
Volume36
Issue number4
DOIs
StatePublished - Apr 2024

Keywords

  • Klatskin
  • cholestasis
  • endoscopic retrograde cholangiopancreatography
  • palliation

Fingerprint

Dive into the research topics of 'Side-by-side placement of fully covered metal stents versus conventional 7F plastic stents in malignant hilar biliary obstruction: Prospective randomized controlled trial'. Together they form a unique fingerprint.

Cite this