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Comparison of the efficacy of covered versus uncovered metallic stents in treating inoperable malignant common bile duct obstruction: a randomized trial.

Authors
 Shin Jae Lee  ;  Man Deuk Kim  ;  Myung Su Lee  ;  Il Jung Kim  ;  Sung Il Park  ;  Jong Yoon Won  ;  Do Yun Lee 
Citation
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.25(12) : 1912-1920, 2014 
Journal Title
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 1051-0443 
Issue Date
2014
MeSH
Adult ; Aged ; Aged, 80 and over ; Blood Vessel Prosthesis Implantation/methods ; Cholestasis, Extrahepatic/etiology* ; Cholestasis, Extrahepatic/surgery* ; Common Bile Duct/surgery ; Diagnostic Imaging/methods ; Digestive System Neoplasms/complications* ; Equipment Design ; Female ; Humans ; Male ; Middle Aged ; Palliative Care/methods* ; Prospective Studies ; Stents* ; Survival Analysis ; Treatment Outcome ; Vascular Patency
Keywords
PTBD ; percutaneous transhepatic biliary drainage
Abstract
PURPOSE: To compare patency and overall survival achieved with covered versus uncovered metallic stents among patients with inoperable malignant extrahepatic biliary obstruction. MATERIALS AND METHODS: There were 40 patients enrolled in this prospective randomized study between January 2012 and July 2013. Mean age of patients was 62.6 years (range, 43-86 y). The malignancies causing extrahepatic biliary obstruction were pancreatic cancer (n = 18), stomach cancer (n = 13), gallbladder cancer (n = 3), common bile duct cancer (n = 2), and other cancer types (n = 4). Uncovered (n = 20) and covered (n = 20) stents were used. Stent patency, overall survival, and complications were evaluated and statistically compared. RESULTS: Mean patency of uncovered stents (413.3 d ± 63.0) was significantly longer than mean patency of covered ones (207.5 d ± 46.0; P = .041). Mean overall survival was 359.9 days ± 61.5 for uncovered stents, which was statistically similar to survival of 350.5 days ± 43.8 for covered stents (P = .271). Causes of recurrent obstruction included tumor ingrowth (n = 2), tumor overgrowth (n = 5), debris or food material (n = 5), and stent migration (n = 2). One case of acute cholecystitis occurred in covered stent group. CONCLUSIONS: Uncovered metallic stents had superior patency duration than covered stents for patients with malignant extrahepatic biliary obstruction. However, the overall complication and survival rates achieved with covered and uncovered stents were similar.
Full Text
http://www.sciencedirect.com/science/article/pii/S105104431400565X
DOI
10.1016/j.jvir.2014.05.021
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Kim, Il Jung(김일중)
Park, Sung Il(박성일)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Do Yun(이도연)
Lee, Myung Su(이명수)
Lee, Shin Jae(이신재)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138938
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