Diamond stents for palliation of malignant bile duct obstruction: a prospective multicenter evaluation.
OBJECTIVE
Various types of self-expandable metal stents have been introduced for biliary drainage in patients with malignant jaundice, showing prolonged patency compared with plastic endoprostheses. However, there has only been prolonged experience with a meaningful number of patients using the Wallstent. We evaluated the Diamond stent, a self-expanding uncoated biliary metal stent, in a prospective uncontrolled multicenter setting.


METHODS
The eligibility criterion was obstructive jaundice due to inoperable malignant disease. Between August 1995 and January 2000, 126 patients, who received a total of 134 Diamond stents in four European centers, were followed prospectively.


RESULTS
Technical and clinical success rates were 96 % and 98 %, respectively. No major procedure-related complications occurred. The 30-day mortality rate was 13 %. Stent occlusion occurred in 28 patients (22 %). Overall median stent patency was 477 days; overall median survival was 173 days. Stent occlusion, confirmed by endoscopic retrograde cholangiopancreatography, was successfully treated with plastic stents in all patients. Cost analysis revealed estimated costs of 3440 euros per patient for palliative treatment with the Diamond stent.


CONCLUSIONS
The Diamond stent compares favorably with other biliary metal stents for patients requiring biliary drainage of malignant jaundice.
Ferlitsch
A
A
Dept. of Internal Medicine IV, Division of Gastroenterology and Hepatology, University of Vienna, Waeringer Guertel 18-20, 1090 Vienna, Austria. arnulf.ferlitsch@akh-wien.ac.at
Oesterreicher
C
C
Dumonceau
J M
JM
Deviere
J
J
Leban
T
T
Born
P
P
Rösch
T
T
Suter
W
W
Binek
J
J
Meyenberger
C
C
Müllner
M
M
Schneider
B
B
Schöfl
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D002779:Cholestasis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D003365:Costs and Cost Analysis; D004067:Digestive System Neoplasms / Q000150:complications* / Q000628:therapy*; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects / Q000191:economics; D016896:Treatment Outcome