Korean J Gastrointest Endosc.  2005 May;30(5):257-261.

A Comparison of Covered Expandable Metal Stent and Uncovered Expandable Metal Stent for the Management of Distal Malignant Biliary Obstruction

• Yoon WJ
• Lee KH
• Lee JK
• Ryu JK
• Kim YT
• Lee WJ
• Yoon YB

Abstract

BACKGROUND/AIMS
Covered self-expandable metal stents (CEMS) were developed to overcome tumor ingrowth which is a problem of uncovered EMS (UEMS). However, the efficacy of CEMS is controversial, and CEMS have problems such as migration and development of cholecystitis.
METHODS
We evaluated 77 cases of endoscopic retrograde biliary drainage using EMS for unresectable distal malignant biliary obstruction in a retrospective setting. Polyurethane-covered Wallstents were used on 36 patients and uncovered Wallstents were used on 41 patients. Early complications and stent patency were analyzed. The end points of this study were stent obstruction or death of the patient.
RESULTS
Stent migration occurred in three of the CEMS group and one of the UEMS group. Cholecystitis occurred in one of the CEMS group but in none of the UEMS group. Acute pancreatitis and bleeding did not occur in both groups. Stent occlusion occurred after a mean of 271 days in the CEMS group and 263 days in the UEMS group.
CONCLUSIONS
Stent patency was comparable between covered and uncovered Wallstent. A large-scale prospective randomized study is needed to evaluate the efficacy and indication of covered Wallstent.

Keyword

Stents; Biliary tract neoplasms; Biliary obstruction

MeSH Terms

Biliary Tract Neoplasms
Cholecystitis
Drainage
Hemorrhage
Humans
Pancreatitis
Retrospective Studies
Stents*