Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 25 July 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy 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

 25 July 2016 
Antibiotic prophylaxis for open colectomies
 25 July 2016 
Steroids in eosinophilic esophagitis
 25 July 2016 
Prevention of post-ERCP pancreatitis
 22 July 2016 
Upper GI lesions at primary diagnosis in IBD
 22 July 2016 
Fecal calprotectin and IBD
 22 July 2016 
Duodenal villous atrophy and celiac disease
 21 July 2016 
Radiofrequency ablation in Barrett's
 21 July 2016 
HCV eradication and inflammation in cirrhotic patients
 21 July 2016 
Surveillance of Barrett's
 20 July 2016 
Nonselective β-blockers and survival in cirrhosis
 20 July 2016 
Adolescent body mass index and and colorectal cancer risk
 20 July 2016 
Genetic biomarkers and IBD treatment response
 19 July 2016 
Prevention of chemotherapy-induced nausea and vomiting
 19 July 2016 
Longterm clinical follow-up of living liver donors
 19 July 2016 
Screening diabetic patients for NAFLD
 18 July 2016 
Rectal neuroendocrine tumors
 18 July 2016 
Liver stiffness measurement in chronic liver disease
 18 July 2016 
Liver cancer prediction scores in Hep B
 15 July 2016 
Patient reported outcomes in celiac disease
 15 July 2016 
Tonsillectomy and IBD risk
 15 July 2016 
Trainee IBD education in the USA
 14 July 2016 
Screening for familial pancreatic cancer
 14 July 2016 
Fecal calprotection for IBD prognosis
 14 July 2016 
Perianal surgery risk in Crohn's
 13 July 2016 
Lung transplant outcomes in Hep C
 13 July 2016 
Psychological comorbidity and postinfectious IBS
 13 July 2016 
Graft selection strategy in living donor liver transplants
 12 July 2016 
Treatment of pediatric acute liver failure
 12 July 2016 
Therapy for iron deficiency anemia in IBD
 12 July 2016 
Surveillance endoscopy in Barrett's esophagus
 11 July 2016 
Transition to adulthood in celiac disease
 11 July 2016 
Factors that influence access to liver transplant
 11 July 2016 
Disturbed sleep and IBS
 08 July 2016 
Mortality and peptic ulcers
 08 July 2016 
Statins and cirrhosis in Hep B
 08 July 2016 
Genetic risk score and body mass index
 07 July 2016 
Predicting food triggers in eosinophilic esophagitis
 07 July 2016 
Extraperitoneal vs transperitoneal colostomy for hernia
 07 July 2016 
Predictors fecal transplant failure in C. diff infection
 06 July 2016 
Therapies for Hep B cure
 06 July 2016 
Hospital volume and liver cancer survival
 06 July 2016 
Adverse events after outpatient colonoscopy
 05 July 2016 
Colorectal surgery and dialysis
 05 July 2016 
Non-invasive scoring systems for fibrosis in NAFLD
 05 July 2016 
Exercise and gastroesophageal reflux
 04 July 2016 
Guidelines on PPI and NSAID prescription
 04 July 2016 
Rectal cancer surgery checklist
 04 July 2016 
Autoimmunity in eosinophilic esophagitis and families
 01 July 2016 
Outcome measures in celiac disease
 01 July 2016 
Growth factor activity and IBD
 01 July 2016 
Aspirin and colorectal cancer
 30 June 2016 
Staging system for familial adenomatous polyposis
 30 June 2016 
Antibiotics in children and obesity
 30 June 2016 
IBS-type symptoms in pediatric IBD
 29 June 2016 
Hep C eradication in people who inject drugs
 29 June 2016 
Anti-tumor necrosis factor in mothers and newborns
 29 June 2016 
Progression to esophageal carcinoma in Barrett's
 28 June 2016 
Gastric cancer screening in the USA
 28 June 2016 
Cancer recurrence after immune-suppressive therapies
 28 June 2016 
Acute severe ulcerative colitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us