Efficacy and safety of the covered Wallstent in patients with distal malignant biliary obstruction.
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.
Nakai
Yousuke
Y
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, Japan.
Isayama
Hiroyuki
H
Komatsu
Yutaka
Y
Tsujino
Takeshi
T
Toda
Nobuo
N
Sasahira
Naoki
N
Yamamoto
Natsuyo
N
Hirano
Kenji
K
Tada
Minoru
M
Yoshida
Haruhiko
H
Kawabe
Takao
T
Omata
Masao
M
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
D020099:Coated Materials, Biocompatible; D012828:Silicones