title: Efficacy and safety of the covered Wallstent in patients with distal malignant biliary obstruction.
abstract: BACKGROUND
  The aim of this study was to evaluate the efficacy and the safety of the covered Wallstent, a commercially available silicone-covered, self-expandable metallic stent (covered Wallstent), for the treatment of distal malignant biliary obstruction.
  
  
  METHODS
  Sixty-nine consecutive patients with unresectable distal malignant biliary obstruction who underwent covered Wallstent placement between October 2001 and October 2003 were studied at 4 affiliated hospitals.
  
  
  RESULTS
  Mean stent patency and mean survival were 139.1 days and 200.9 days, respectively. Stent occlusion occurred in 7 cases (10.1%), but tumor ingrowth was not observed. Seventeen complications, including 5 cholangitis (7.2%), 4 stent migration (5.8%), 4 cholecystitis (5.8%), and 4 pancreatitis (5.8%) were observed in 16 patients (23.2%). Stent misplacement was observed in 7 patients (10.1%).
  
  
  CONCLUSIONS
  Covered Wallstent is effective in preventing tumor ingrowth for the treatment of distal malignant biliary obstruction. However, the overall complication rate may be higher than uncovered self-expanding metal stents and covered self-expanding metal stents of different design.
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, University of Tokyo, Japan.
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Nakai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Komatsu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsujino
authors.forename: Nobuo
authors.initials: N
authors.lastname: Toda
authors.forename: Naoki
authors.initials: N
authors.lastname: Sasahira
authors.forename: Natsuyo
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirano
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshida
authors.forename: Takao
authors.initials: T
authors.lastname: Kawabe
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000150:complications*; D001651:Cholestasis, Extrahepatic / Q000209:etiology / Q000601:surgery*; D020099:Coated Materials, Biocompatible; D003137:Common Bile Duct Diseases / Q000209:etiology / Q000601:surgery*; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications*; D012828:Silicones; D015607:Stents / Q000009:adverse effects
chemical_list: D020099:Coated Materials, Biocompatible; D012828:Silicones