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

 01 September 2014

Advanced search
 01 September 2014 
Risks with anti-TNF in pediatric IBD
 01 September 2014 
Genetic variants in alcoholic liver disease
 01 September 2014 
Fecal hemoglobin and colorectal cancer screening
 29 August 2014 
Gluten-free diet for asymptomatic celiac disease
 29 August 2014 
NSAID-induced small intestinal injury and diaphragm disease
 29 August 2014 
Symptom evaluation in functional dyspepsia
 28 August 2014 
Predictoris of C. diff in out-patients
 28 August 2014 
Detection of gastroesophageal reflux symptoms
 28 August 2014 
Colorectal-cancer mortality after adenoma removal
 27 August 2014 
Endoscopy outcomes in community hospital vs tertiary academic centers
 27 August 2014 
UV exposure and IBD hospitalizations
 27 August 2014 
Hepatocellular carcinoma screening in liver disease
 26 August 2014 
NAFLD and gastroesophageal reflux symptoms
 26 August 2014 
Adalimumab-treated patients with ulcerative colitis
 26 August 2014 
Wound healing after abdominoperineal resection
 25 August 2014 
Surgical management of rectourethral fistulas
 25 August 2014 
Biomarker analysis in biopsies for ulcerative colitis
 25 August 2014 
Ileocolic resection in Crohn's disease
 22 August 2014 
Outlier identification in colorectal surgery
 22 August 2014 
Endoscopic submucosal dissection for squamous esophageal cancer
 22 August 2014 
Adherence to Rome criteria in functional dyspepsia trials
 21 August 2014 
Screening for Barrett’s esophagus
 21 August 2014 
Colorectal cancer mortality in Brazil
 21 August 2014 
Eosinophilic esophagitis
 20 August 2014 
Rectal surgery mortality
 20 August 2014 
Chemotherapy-induced gastrointestinal mucositis
 20 August 2014 
Stool methylated DNA markers and colorectal cancer resection
 19 August 2014 
Recurrent C. difficile infection in out-patients
 19 August 2014 
Racial disparities and colon cancer
 19 August 2014 
Variability of colonoscopy preparation instructions
 18 August 2014 
The evolution of urban C. difficile
 18 August 2014 
Metabolomic analysis in IBD
 18 August 2014 
Enhanced T-cell response in acute-on-chronic Hep B
 15 August 2014 
Abdominal pain in IBS
 15 August 2014 
Gene expression biomarker in ulcerative colitis
 15 August 2014 
Population-based fecal immunochemical test screening
 14 August 2014 
Transnasal vs transoral endoscopy
 14 August 2014 
Radiation exposure in gastroenterology
 14 August 2014 
Dietary fibre and diverticular disease
 13 August 2014 
Fecal immunochemical test screening
 13 August 2014 
Adherence to Rome criteria in functional dyspepsia
 13 August 2014 
Flexible sigmoidoscopy screening
 12 August 2014 
Eosinophilic esophagitis and celiac disease
 12 August 2014 
Management of Lynch syndrome
 12 August 2014 
Risk of cancer under immunosuppressive therapy in IBD
 11 August 2014 
Gut microbiota in chemotherapy-induced GI mucositis
 11 August 2014 
Risk of GI bleeds with anticoagulants
 11 August 2014 
Social media in health-care
 08 August 2014 
Endoscopy nurse-administered propofol sedation performance
 08 August 2014 
Therapy for biliary tract cancer
 08 August 2014 
Surgeon volume and esophagectomy survival
 07 August 2014 
Global consensus on perianal fistulizing Crohn's disease
 07 August 2014 
Smoking cessation and age of onset of ulcerative colitis
 07 August 2014 
Colonoscopy length and training duration
 06 August 2014 
Hepatitis C virus infection in the United States
 06 August 2014 
Pediatric to adult IBD care
 06 August 2014 
Biomarker of disease activity in IBD
 05 August 2014 
Rising incidence of celiac disease
 05 August 2014 
Socioeconomic status and IBS
 05 August 2014 
Bowel dysfunction after sphincter-preserving rectal 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