Korean J Gastrointest Endosc.  2009 Sep;39(3):149-153.

Management of Occluded Biliary Uncovered Metal Stents: Covered Self Expandable Metallic Stent vs. Uncovered Self Expandable Metallic Stent

• Jung KS
• Jung WJ
• Kim DU
• Choi CW
• Kang DH

Abstract

BACKGROUND/AIMS
Unresectable malignant biliary obstruction has usually been treated by placement of a self-expandable metallic stent (SEMS). One of the major complications of SEMS is occlusion of the stent by the ingrowth and overgrowth of tumor. The optimal management of an occluded SEMS is still an unresolved problem. We performed this study to evaluate the usefulness of placing a second stent with using an uncovered SEMS or a covered SEMS in patients with stent occlusion.
METHODS
From January 2006 to December 2007, a total of 163 patients were treated with the placement of an uncovered SEMS for treating malignant biliary obstruction, except for the cases with Klatskin's tumor. Thirty four patients were occluded and they underwent a second SEMS insertion. All the patients with an occluded uncovered SEMS were managed with placement of a covered SEMS or an uncovered SEMS by ERCP.
RESULTS
The median patent duration after intervention was 98 days (range: 8~300 days) after the second covered SEMS insertion, and the median patent duration after intervention was 90 days (range: 10~643 days) after the second uncovered SEMS insertion. No significant difference in the patent period was observed between the covered SEMS group and the uncovered SEMS group (P=0.832).
CONCLUSIONS
The covered SEMS group and the uncovered SEMS group had similar patent periods for the management of occluded uncovered metal stents.

Keyword

Occluded SEMS; Uncovered SEMS; Covered SEMS

MeSH Terms

Cholangiopancreatography, Endoscopic Retrograde
Humans
Klatskin's Tumor
Stents