title: Biliary stenting for benign and malignant obstructive jaundice: safe use of extended stent-change intervals.
abstract: OBJECTIVE
  This study compared 2 methods of palliative stent placement, 6-monthly interval stent changes (RS), or a single-stent policy with no planned stent change (SS).
  
  
  RESULTS
  A total of 460 patients were identified. There were no significant differences in the proportion of patients requiring unplanned stent changes in the RS or SS group (22.3% vs. 22.8%). Median survival was not significantly different between the RS and SS groups, for both benign disease (96 vs. 92 mo) and malignant disease (9 vs. 6 mo). Patients undergoing unplanned stent changes had the poorest survival and the highest stent change-related complication rate. Patients with a blocked stent episode were more likely to develop further problems with stent patency, within a median interval of 2.5 months.
  
  
  CONCLUSIONS
  In carefully selected patients, a single stent may be adequate with no planned change of stent. There appears to be a clearly defined subgroup of patients who have recurrent problems with stent patency; these should have their interval exchange brought forward on a 3-monthly basis, or a self-expanding metal stent should be used.
authors: Department of Hepatobiliary and Pancreatic Surgery, University Hospitals of Leicester, Leicester, UK.
authors: Mayar G
authors: MG
authors: Aswad
authors: Ashley R
authors: AR
authors: Dennison
authors: Christopher P
authors: CP
authors: Neal
authors: Matthew S
authors: MS
authors: Metcalfe
authors: Giuseppe
authors: G
authors: Garcea
mesh_terms: D000368:Aged; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D041781:Jaundice, Obstructive / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome