title: Efficacy of covered metallic stents in the treatment of unresectable malignant biliary obstruction.
abstract: We evaluated the efficacy of covered stents for malignant biliary obstruction. We studied 62 patients with obstruction distal to the hilar confluence who survived longer than 10 weeks and divided them into a covered stent group (group 1, n = 22), a Z stent group (group 2, n = 19), and a mesh stent group (group 3, n = 21), according to their type of the stent. Patency rates of each group were compared. Early stent revision was required after 3 days in 18% (4/22) of group 1, 26% (5/19) of group 2, and 0% (0/21) of group 3. The 10, 20, and 40-week primary patency rates were 77%, 77%, and 59% (group 1), 42%, 25%, and 8% (group 2), and 76%, 71%, and 55% (group 3), respectively. Primary patency rates of groups 1 and 3 were significantly higher than those of group 2 (p < 0.05), and there was no statistically difference between those of group 1 and group 3. The 10, 20, and 40-week assisted primary (secondary) patency rates were 96%, 96%, and 96% (group 1), 68%, 49%, and 39% (group 2), and 86%, 74%, and 58% (group 3), respectively. Assisted primary patency (secondary) rates of group 1 were significantly higher than those of groups 2 and 3 (p < 0.01 and p < 0.05, respectively). Our study suggests that the primary patency rates of the covered stents are equal to those of mesh stents, but these may be improved further if covered stents, which avoid the need for early revision, are used.
authors.affiliation: Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1, Funabashi, Wadanaka-cho, Fukui 918-8503, Japan. s-miyayama@fukui.saiseikai.or.jp
authors.forename: Shiro
authors.initials: S
authors.lastname: Miyayama
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsui
authors.forename: Yukari
authors.initials: Y
authors.lastname: Akakura
authors.forename: Toru
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Hiroto
authors.initials: H
authors.lastname: Nishida
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoneda
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kawai
authors.forename: Daisyu
authors.initials: D
authors.lastname: Toya
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mitsui
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Asada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome