Metal versus plastic stents for drainage of malignant biliary obstruction before primary surgical resection

Abstract

In patients with resectable malignant biliary obstruction, the outcomes of PBD with plastic stents and FCSEMSs were similar. Considering the cost-effectiveness, PBD with plastic stents may be preferable to FCSEMS placement. (Clinical trial registration number: NCT01789502.).

Modified non‐flared fully covered self‐expandable metal stent versus plastic stent for preoperative biliary drainage in patients with resectable malignant biliary obstruction

“…However, duct injuries or de novo stent‐induced strictures caused by tissue hyperplasia can occur . FCSEMS may be also associated with post‐ERCP pancreatitis (PEP) by covering the pancreatic duct orifice . These ischemic changes around the area of stent placement and PEP are causes of delaying the operation and affecting surgical outcome.…”

“…These ischemic changes around the area of stent placement and PEP are causes of delaying the operation and affecting surgical outcome. As a result, a recent prospective randomized controlled trial did not identify superiority of PBD using C‐FCSEMS compared with PS . Thus, the routine use of FCSEMS in surgical candidates was initially avoided because of concern that a metallic foreign body may lead to local inflammation and make surgical resection more technically challenging, resulting in an increased rate of perioperative AEs …”

“…16,17 FCSEMS may be also associated with post-ERCP pancreatitis (PEP) by covering the pancreatic duct orifice. 12,18 These ischemic changes around the area of stent placement and PEP are causes of delaying the operation and affecting surgical outcome. As a result, a recent prospective randomized controlled trial did not identify superiority of PBD using C-FCSEMS compared with PS.…”

Outcomes of preoperative biliary drainage from a single tertiary center: Is there still a role for plastic stents?

“…A relatively long interval between stent placement and surgery was reported in most of these studies, ranging from 4 weeks to 4 months, which probably favored FCSEMS outcomes . The only prospective RCT comparing FCSEMS and PS for PBD was published recently . In this multicenter trial from South Korea, 86 patients with malignant biliary obstruction who were randomly assigned to one of the two modalities had similar outcomes.…”

The safety and efficacy of nasobiliary drainage versus biliary stenting in malignant biliary obstruction

“…Moreover, obstructive jaundice resulting from MBO may lead to coagulopathy, liver function decline, and pre- or postoperative cholangitis. [2] As the severity of the disease increases, there are more complications, such as renal dysfunction, hepatic failure, and other adverse outcomes. [3] …”