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

 03 July 2015

Advanced search
 03 July 2015 
Tumors with mismatch-repair deficiency
 03 July 2015 
Aptitude of trainees in endoscopic ultrasonography
 03 July 2015 
Extracolonic pathologies in colorectal cancer
 02 July 2015 
Ulcerative colitis prognosis after thiopurines withdrawal
 02 July 2015 
Health care use by IBD children
 02 July 2015 
Anastomotic leak and cancer cancer
 01 July 2015 
Oral mechanical bowel preparation
 01 July 2015 
Missed gastric cancers
 01 July 2015 
Probiotics in IBD
 30 June 2015 
Split-dose preparations vs day-before bowel cleansing regimens
 30 June 2015 
Glucocorticoids and peptic ulcer bleeding
 30 June 2015 
NSAIDs and hearburn symptoms
 29 June 2015 
Prevention of pancreatitis after ERCP
 29 June 2015 
Advances in autoimmune pancreatitis
 29 June 2015 
Rescue therapy in ulcerative colitis
 26 June 2015 

Gene polymorphism in alcoholic liver disease

 26 June 2015 
Dietary fibre–microbiota interactions
 26 June 2015 
Gastritis in celiac disease
 25 June 2015 
Persistent organ failure in acute cholangitis patients
 25 June 2015 
Vitamin D level and primary biliary cirrhosis
 25 June 2015 
Fecal microbiota in pediatric IBD
 24 June 2015 
Fatigue scales for IBD
 24 June 2015 
Mucosal healing tests in ulcerative colitis
 24 June 2015 
Environmental risk in IBD
 23 June 2015 
Marker associated with endoscopic lesion in Crohn's
 23 June 2015 
Body composition in children with IBD
 23 June 2015 
Medical vs nurse endoscopists
 22 June 2015 
Gene polymorphism associated with increased liver enzymes
 22 June 2015 
Treatment of uncomplicated acute appendicitis
 22 June 2015 
Solid organ cancers after liver transplant
 19 June 2015 
Causes of death in HBV
 19 June 2015 
Lifetime benefits of increased adenoma detection rates
 19 June 2015 
Acid-suppressive therapy before anti-reflux surgery
 18 June 2015 
Risk for dyspepsia
 18 June 2015 
Endoscopic activity in symptomatic IBD patients
 18 June 2015 
Regimens for H. pylori eradication
 17 June 2015 
NAFLD risk in celiac disease
 17 June 2015 
Non-invasive markers of advanced liver fibrosis
 17 June 2015 
Patients’ and clinicians’ perception of pouch dysfunction
 16 June 2015 
Risk score for hepatocellular carcinoma screening
 16 June 2015 
Esophageal food bolus impaction
 16 June 2015 
Evaluating lymph node metastasis for rectal cancer
 15 June 2015 
Low-cost colonoscopy training
 15 June 2015 
Determining dysbiosis in IBS or IBD
 15 June 2015 
Light alcohol consumption and NAFLD
 12 June 2015 
Smoking and disease course in IBD
 12 June 2015 
Hep D in a Hep B endemic area
 12 June 2015 
Patient-orientated internet information in ulcerative colitis
 11 June 2015 
Physical inactivity and NAFLD
 11 June 2015 
Esophageal stricture after endoscopic resection
 11 June 2015 
Guideline based screening strategies for hepatitis
 10 June 2015 
Cost-effectiveness of HCV treatment in liver disease
 10 June 2015 
Abdominoperineal excision for low rectal cancer
 10 June 2015 
Pediatric chronic Hep C
 09 June 2015 
Bile acid malabsorption in IBS
 09 June 2015 
Racial differences in celiac disease
 09 June 2015 
Conversion from laparoscopic to open colorectal cancer resection
 08 June 2015 
Short sleep duration and NAFLD
 08 June 2015 
Heritability in inflammatory bowel disease
 08 June 2015 
Eosinophilic esophagitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us