title: A comparison of the Niti-D biliary uncovered stent and the uncovered Wallstent in malignant biliary obstruction.
abstract: BACKGROUND
  The conformability of uncovered self-expandable metal stents (SEMSs) plays an important role in maintaining stent patency. However, whether increased conformability can prolong the duration of SEMS patency remains to be proved.
  
  
  OBJECTIVE
  The aim of this study was to examine the efficacy and complication rates of the Niti-D biliary uncovered metal stent (NDS), which is more conformable than the uncovered Wallstent.
  
  
  METHODS
  Nonrandomized, retrospective study.
  
  
  METHODS
  Tertiary-care academic medical center.
  
  
  METHODS
  From March 2005 to July 2007, 101 patients received an NDS (41 cases) or a Wallstent (60 cases) for malignant biliary obstruction.
  
  
  METHODS
  SEMS placement.
  
  
  RESULTS
  Stent occlusion occurred in 11 patients (26.8%) with the NDS and 17 patients (28.3%) with the Wallstent. The median duration of stent patency tended to be longer for the NDS group (153 days) than for the Wallstent group (124 days); however, the difference was not statistically significant (P = .204). The median duration of overall survival of patients was 160 days for the NDS and 148 days for the Wallstent. The subgroup analysis showed that 27 patients had hilar obstruction (NDS 13, Wallstent 14). The median duration of stent patency was 249 days for the NDS group and 76 days for the Wallstent group; this difference was statistically significant (P = .006). The complications included pancreatitis in 3 NDS cases and 5 Wallstent cases.
  
  
  CONCLUSIONS
  The absence of prospective randomized recruitment.
  
  
  CONCLUSIONS
  The results of this study showed no significant differences between the NDS and the Wallstent for the palliative endoscopic management of malignant biliary obstruction. There were no significant differences in patency, complication rates, and patient survival between the more conformable NDS and the conventional Wallstent. However, the NDS, which has good conformability, may be preferred for hilar obstruction.
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Ki Young
authors: KY
authors: Yang
authors: Ji Kon
authors: JK
authors: Ryu
authors: Jeong Kyun
authors: JK
authors: Seo
authors: Sang Myung
authors: SM
authors: Woo
authors: Joo Kyung
authors: JK
authors: Park
authors: Yong-Tae
authors: YT
authors: Kim
authors: Yong Bum
authors: YB
authors: Yoon
mesh_terms: D001650:Bile Duct Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001706:Biopsy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D020099:Coated Materials, Biocompatible; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible