A comparison of the Niti-D biliary uncovered stent and the uncovered Wallstent in malignant biliary obstruction.
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.
Yang
Ki Young
KY
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Ryu
Ji Kon
JK
Seo
Jeong Kyun
JK
Woo
Sang Myung
SM
Park
Joo Kyung
JK
Kim
Yong-Tae
YT
Yoon
Yong Bum
YB
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
D020099:Coated Materials, Biocompatible