Background and study aims: The patency of self-expandable metallic stents (SEMS) is known to be better than
plastic stents in the palliation of malignant biliary obstruction. However, data are
scarce for obstructive jaundice caused by hepatocellular carcinoma (HCC). This study
aimed to compare SEMSs and plastic stents for the palliation of obstructive jaundice
in unresectable HCC.
Patients and methods: A total of 96 patients who underwent endoscopic retrograde biliary drainage with SEMSs
or plastic stents were included in this retrospective analysis. The rate of successful
biliary drainage, adverse events, stent patency duration, and patient survival were
compared between the SEMS (n = 36) and plastic stent (n = 60) groups.
Results: The rate of successful biliary drainage was similar between the SEMS and plastic stent
groups (25/36 [69.4 %] vs. 39/60 [65.0 %]; P = 0.655). Adverse events occurred in 6 patients (16.7 %) in the SEMS group and 13
patients (21.7 %) in the plastic stent group (P = 0.552). The median patency duration was also similar between the two groups (60
vs. 68 days; P = 0.396). The median patient survival was longer in the plastic stent group than in
the SEMS group (123 vs. 48 days; P = 0.005).
Conclusions: SEMSs were not superior to plastic stents for the palliation of malignant biliary
obstruction in HCC with regard to successful drainage, stent patency, and adverse
events. Patient survival was better in the plastic stent group. Given the lower cost,
plastic stents could be a favorable option for malignant biliary obstruction caused
by HCC.
