Endoscopy 2018; 50(04): S43
DOI: 10.1055/s-0038-1637155
ESGE Days 2018 oral presentations
20.04.2018 – ERCP 2: bile duct stenosis
Georg Thieme Verlag KG Stuttgart · New York

SUPRAPAPILLARY BILIARY STENT PLACEMENT MIGHT HAVE LONGER PATENCY TIME COMPARED TO TRANSPAPILLARY STENT PLACEMENT – A SYSTEMATIC REVIEW AND META-ANALYSIS

D Pécsi
1   University of Pécs, Institute for Translational Medicine, Pécs, Hungary
,
N Farkas
2   University of Pécs, Institute of Bioanalysis, Pécs, Hungary
,
P Hegyi
1   University of Pécs, Institute for Translational Medicine, Pécs, Hungary
,
K Márta
1   University of Pécs, Institute for Translational Medicine, Pécs, Hungary
,
Z Szakács
1   University of Pécs, Institute for Translational Medicine, Pécs, Hungary
,
A Vincze
3   University of Pécs, First Department of Medicine, Pécs, Hungary
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

 

Aims:

Endoscopic biliary stent placement is a widely-accepted method for the treatment of patients with biliary stricture of benign or malignant etiology. Stent patency and function time are crucial factors in this therapeutic modality. Suprapapillary versus transpapillary stent positioning might be a contributory factor in stent function time, for that reason we aimed to conduct a meta-analysis in this comparison.

Methods:

A comprehensive literature search was conducted to find articles containing data on suprapapillary stent placement compared to the standard transpapillary method in cases of biliary stenosis of any etiology and any stent type until April 2017. 3891 articles were identified: 1909, 754 and 1228 in EMBASE, PubMed and Cochrane Library, respectively. Nine studies fit the inclusion criteria. A meta-analysis was carried out focusing on the following outcomes: stent patency, stent dislocation, cholangitis, pancreatitis and other reported complications rate. Three prospective and six retrospective studies were included in this systematic review and meta-analysis.

Results:

Suprapapillary stent placement seemed to be superior to transpapillary stent position in patency (standard difference in means 0.961; standard error 0.294 [0.294 – 1.538]; p = 0.001). In the subgroup analysis of plastic stents suprapapillary positioning showed a lower rate of occlusion (odds ratio (OR) 0.299 [0.125 – 0.718]; p = 0.007; 75 vs. 88), cholangitis (Peto's OR (POR) 0.183 [0.060 – 0.554]; p = 0.003; 66 vs. 68), and pancreatitis (POR 0.340 [0.127 – 0.907]; p = 0.031; n = 171 vs. 239) compared to transpapillary stent placement. There was no difference in the stent migration rates between the two groups (POR 0.728 [0.092 – 5.770]; p = 0.763; n = 183 vs. 256).

Conclusions:

Suprapapillary stenting may have the advantage of longer stent patency, lower cholangitis and pancreatitis rate in the cases of plastic stent placement. Moreover, the stent migration rate did not differ in the suprapapillary and transpapillary groups.