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 21 February 2018

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News

Comparison of stents for malignant distal common bile duct strictures

Physicians in the December issue of Endoscopy compare 2 different stents in patients with malignant distal common bile duct strictures.

News image

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Endoscopic biliary stenting is an established treatment for malignant obstructive jaundice. However, stent clogging remains a problem with plastic stents.

In this study, physicians from Europe made a prospective comparison of 2 stents that were constructed of different materials and were differing shapes.

The team assessed 120 patients with jaundice due to malignant strictures of the middle to distal third of the common bile duct. They excluded patients with cholangitis, hemobilia, previous biliary drainage, hilar stricture, or ampullary cancer.

Patients were randomly assigned to receive either an Olympus DoubleLayer stent or a standard polyethylene stent.

The DoubleLayer stents had a significantly longer patency period.
Endoscopy

The physicians found that 47% of patients in the DoubleLayer stent group and 29% of patients in the polyethylene stent group died without evidence of stent occlusion.

They also found that 43% of patients in the DoubleLayer group had symptoms of stent clogging after a mean of 144 days. This compared with 63% of patients in the polyethylene group, who had symptoms of clogging after a mean of 99 days.

The team identified stent dysfunction in 10% of the DoubleLayer patients (10 %) and 8% of the polyethylene patients. This difference was not significant.

The team's analysis showed that the DoubleLayer stents had a significantly longer patency period.

Dr Tringali's team concluded, "These results show that DoubleLayer stents have a longer patency period than polyethylene stents".

"Patients who received polyethylene stents had a higher risk of stent occlusion…before death than DoubleLayer stent patients".

Endoscopy 2003; 35(12): 992-7
02 December 2003

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