title: A prospective randomized study comparing partially covered metal stent versus plastic multistent in the endoscopic management of patients with postoperative benign bile duct strictures: a follow-up above 5 years.
abstract: BACKGROUND
  Self-expandable metal stents (SEMS) are often used for biliary drainage due to obstruction of neoplastic etiology, with better results than plastic stents, but seldom for biliary drainage of benign etiology.
  
  
  OBJECTIVE
  Primary end point: Verify bile duct patency after placement of self-expandable metal and (multiple) plastic stents in patients with benign strictures resulting from bile duct surgery with follow-up above five years. Secondary end point: Evaluate long-term complication rate in patients with metal self-expandable and plastic stents.
  
  
  RESULTS
  Self-expandable stents were placed in 15 patients and multiple plastic stents in 16. Mean age was 45 years with prevalence of female patients in both groups and no statistical difference between groups was observed (SEMS: 66.7%; plastic multistent: 62.5%; p=0.8). Complication rate resulting from stents occurred more often in the metal stent group (40% versus 25%; p=0.37). In the metal stent group, most frequent complications were hemorrhage (n=3; 20%), stent migration (n=2; 13.3%) and perforation (n=1; 6.7%). In plastic multistent group, most frequent complications were perforation (n:2; 12.5%), hemorrhage (n=1; 6.2%) and ulcer (n=1; 6.2%). Long-term patency rate after biliary drainage was higher in the self-expandable metal stent group, SEMS: 81.67% ± 2.56; CI: 76.47-86.54; plastic multistent: 71.88% ± 2.93; CI: 66.08-77.27.
  
  
  CONCLUSIONS
  The temporary passage of partially covered self-expandable metal stents is a feasible option for patients with benign bile duct strictures.
authors.affiliation: Departamento de Cirurgia, Hospital Ana Costa, Santos, Brazil.
authors.forename: Everson L A
authors.initials: EL
authors.lastname: Artifon
authors.forename: Flavio
authors.initials: F
authors.lastname: Coelho
authors.forename: Mariana
authors.initials: M
authors.lastname: Frazao
authors.forename: Sergio
authors.initials: S
authors.lastname: Marques
authors.forename: Jose B
authors.initials: JB
authors.lastname: Paione
authors.forename: Jonas
authors.initials: J
authors.lastname: Takada
authors.forename: Paulo
authors.initials: P
authors.lastname: Boaventura
authors.forename: Carolina
authors.initials: C
authors.lastname: Rebello
authors.forename: José
authors.initials: J
authors.lastname: Pinhata Otoch
mesh_terms: D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation / Q000379:methods; D002779:Cholestasis / Q000209:etiology / Q000628:therapy*; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome