Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

No benefit of covered vs uncovered self-expandable metal stents for malignant distal biliary obstruction

The latest issue of Clinical Gastroenterology & Hepatology compares covered vs uncovered self-expandable metal stents in patients with malignant distal biliary obstruction.

News image

Self-expandable metal stents (SEMS) are used in patients with malignant distal biliary obstruction.

Trials that compared covered and uncovered SEMS reported different results because of heterogeneous designs and patient populations.
 
These studies compared patency of uncovered SEMS and covered SEMS, along with rates of pancreatitis, cholecystitis, cholangitis, SEMS migration, bleeding, perforation, and recurrent biliary obstruction.

Dr Majid Almadi and colleagues from Canada performed a meta-analysis to compare the effects of covered and uncovered SEMS in patients with malignant distal biliary obstruction.

The researchers identified randomized controlled trials by using a literature search from 1980 through 2012.

The research team observed evaluated data from 5 full articles and 4 abstracts, comprising 1061 patients, and assessed statistical heterogeneity and publication bias.

The weighted mean difference in the stent patency duration could only be calculated on the basis of 2 studies, but it was 68 days longer for covered SEMS than for uncovered SEMS.

Patients with covered SEMS had a higher rate of tumor overgrowth
Clinical Gastroenterology & Hepatology

The doctors noted that a summary analysis of data from 4 trials demonstrated no differences in patency of covered vs uncovered SEMS after 6 months or 12 months.

There were also no differences in the rates of pancreatitis, cholecystitis, perforation, bleeding, or cholangitis, length of hospital stay, or number of recurrent biliary obstructions.

The researches found that covered SEMS had a higher migration rate.

Patients with covered SEMS had a lower rate of tumor ingrowth but a higher rate of tumor overgrowth.

The research team reported that no summary calculations could be completed to confidently assess patient survival.

Dr Almadi's team concluded, "The use of covered SEMS, compared with uncovered SEMS, in patients with distal malignant biliary obstruction is of unclear benefit."

"Covered SEMS have a higher rate of migration and do not appear to have longer patency."

Clin Gastroenterol Hepatol 2013:(11)1:27-37
14 January 2013

Go to top of page Email this page Email this page to a colleague

 31 July 2014

Advanced search
 31 July 2014 
Diverticular disease and colon cancer
 31 July 2014 
Biomarkers in liver fibrosis
 31 July 2014 
Risk factors of large colorectal polyps
 30 July 2014 
Small intestinal permeability in diarrhea predominant IBS
 30 July 2014 
Mineral rich water and constipation
 30 July 2014 
Interval between screening colonoscopies
 29 July 2014 
Fluticasone in eosinophilic esophagitis
 29 July 2014 
Causes of GI bleeding in cirrhosis
 29 July 2014 
ALT increases in Hep B
 28 July 2014 
Statins reduce Barrett's
 28 July 2014 
Score predicts risk for Barrett’s esophagus
 28 July 2014 
Gastric cancer prevention
 25 July 2014 
De-escalation of therapy in IBD
 25 July 2014 
Bionic pancreas in type 1 diabetes
 25 July 2014 
Primary care physician counselling and colonoscopy
 24 July 2014 
Diagnostic tool for obscure-overt GI bleeding
 24 July 2014 
Statin use and Barrett’s esophagus
 24 July 2014 
Atopy and functional GI disorders
 23 July 2014 
Sofosbuvir and ribavirin for Hep C
 23 July 2014 
Early corticosteroids after the diagnosis of ulcerative colitis
 23 July 2014 
C-section and IBD risk
 22 July 2014 
Thromboembolism in IBD
 22 July 2014 
Alcohol and colorectal adenoma risk
 22 July 2014 
Cognitive behavioral therapy in IBS
 21 July 2014 
Stents to prevent post-ERCP pancreatitis
 21 July 2014 
Psychometric validation of IBS symptom severity
 21 July 2014 
Mortality in IBD
 18 July 2014 
Treatment of enteropancreatic neuroendocrine tumors
 18 July 2014 
Ulcer complications and dyspeptic symptoms
 18 July 2014 
ERCP with overtube-assisted enteroscopy
 17 July 2014 
Treatment of H. pylori
 17 July 2014 
Ultrasound for diagnosis of gastric varices
 17 July 2014 
Small intestinal permeability in diarrhea predominant IBS
 16 July 2014 
Mortality after colectomy in IBD
 16 July 2014 
Esophageal cancer missed at endoscopy
 16 July 2014 
Screening for Hepatitis B
 15 July 2014 
Diagnosing diverticulitis
 15 July 2014 
Variation in management decisions for colorectal cancer
 15 July 2014 
Muscle cramps in cirrhosis
 14 July 2014 
Predicting the course of ulcerative colitis
 14 July 2014 
Choice in colorectal cancer screening tests
 14 July 2014 
Adhesions in abdominal surgery
 11 July 2014 
Temporal evolution of antidrug antibodies in IBD
 11 July 2014 
Atopy and functional gastrointestinal disorders
 11 July 2014 
Fecal microbiota transplant for C. diff
 10 July 2014 
Acid-suppressive medications and cancer risk in Barrett's
 10 July 2014 
Personalized medicine in the management of IBD
 10 July 2014 
Pregnancy outcome in anti-TNF treated women with IBD
 09 July 2014 
Quality of care provided to patients with varices
 09 July 2014 
Eosinophilic esophagitis and celiac disease
 09 July 2014 
Diagnosis and management of adult celiac disease
 08 July 2014 
Screening for Hep B
 08 July 2014 
NSAID-induced small intestinal injury
 08 July 2014 
Drug-induced liver injury
 07 July 2014 
Obesity and complications after lapaproscopic colorectal surgery
 07 July 2014 
Everolimus and advanced hepatocellular carcinoma
 07 July 2014 
Pediatric celiac disease risk factors
 04 July 2014 
Day-case vs inpatient laparoscopic fundoplication
 04 July 2014 
Alcohol assessment in liver transplant
 04 July 2014 
Clinical competence in colorectal cancer surgery

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us