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Endoscopy 2015; 47(06): 508-516
DOI: 10.1055/s-0034-1391304
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Self-expandable metallic stents vs. plastic stents for endoscopic biliary drainage in hepatocellular carcinoma

Kwang Hyun Chung
1   Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
,
Sang Hyub Lee
1   Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
,
Jin Myung Park
1   Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
3   Department of Internal Medicine, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea.
,
Jae Min Lee
1   Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
4   Department of Internal Medicine, Myongji Hospital, Goyang, Republic of Korea
,
Dong-Won Ahn
2   Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
,
Ji Kon Ryu
1   Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
,
Yong-Tae Kim
1   Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
› Author Affiliations
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Publication History

submitted 23 June 2014

accepted after revision 19 November 2014

Publication Date:
15 January 2015 (online)

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Commentaire du travail de Chung KH et al., pp. 508Endoscopy 2015; 47(06): 570-571
DOI: 10.1055/s-0035-1547095

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.

Figure e2

 

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