title: Efficacy of plastic tube stents without side holes for middle and lower biliary strictures.
abstract: BACKGROUND
  Although biliary expandable metallic stents (EMS) improve patency, they are unsuitable for primary biliary stenting. Although plastic tube stents without side holes (PWOS) are also reported to prolong patency, their efficacy remains controversial.
  
  
  OBJECTIVE
  To evaluate clinical utility and relative advantages, we reviewed clinical results of three types of stents: plastic tube stents with side holes (PS), PWOS, and EMS.
  
  
  METHODS
  The 130 patients comprised 56 with pancreatic cancers, 26 with gallbladder cancers, 21 with bile duct cancers, and 27 with other malignant diseases. Plastic tube stents with side holes (10 French [Fr]), PWOS (10 Fr), and EMS (30 Fr) were inserted in 64, 28, and 38 cases, respectively.
  
  
  RESULTS
  Overall cumulative stent patency rates for EMS and PWOS groups were significantly higher than that of PS. This was also the case with middle and lower biliary tract strictures and with pancreas cancers. In Japan, medical costs with endoscopic retrograde cholangiopancreatography ($631.00) divided by the mean patent period with PS, PWOS, and EMS were $8.80/d, $4.60/d, and $20.40/d, respectively.
  
  
  CONCLUSIONS
  We recommend PWOS for primary biliary stenting of middle and lower biliary strictures, especially those caused by pancreatic cancer, based on its lower price and sufficient patency without replacement after diagnosis of inoperability.
authors.affiliation: First Department of Internal Medicine, Nagoya City University, Medical School, Nagoya, Japan. soichi@med.nagoya-cu.ac.jp
authors.forename: Soichi
authors.initials: S
authors.lastname: Nakamura
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ohara
authors.forename: Tamaki
authors.initials: T
authors.lastname: Yamada
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakazawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sano
authors.forename: Hakuji
authors.initials: H
authors.lastname: Ando
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kajino
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ando
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nomura
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Okayama
authors.forename: Atsuo
authors.initials: A
authors.lastname: Uchida
authors.forename: Masayuki
authors.initials: M
authors.lastname: Iida
authors.forename: Makoto
authors.initials: M
authors.lastname: Itoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000209:etiology / Q000601:surgery*; D016009:Chi-Square Distribution; D003251:Constriction, Pathologic / Q000601:surgery; D003362:Cost-Benefit Analysis; D004322:Drainage / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011095:Polyethylenes; D012189:Retrospective Studies; D015607:Stents / Q000191:economics; D016896:Treatment Outcome
chemical_list: D011095:Polyethylenes