title: Endoscopic Biliary Stenting Versus Percutaneous Transhepatic Biliary Stenting in Advanced Malignant Biliary Obstruction: Cost-effectiveness Analysis.
abstract: OBJECTIVE
  This study aims to compare the clinical outcomes and costs between endoscopic biliary stenting (EBS) and percutaneous transhepatic biliary stenting (PTBS).
  
  
  METHODS
  We randomly assigned 112 patients with unresectable malignant biliary obstruction 2006 and 2011 to receive EBS or PTBS with self-expandable metal stent (SEMS) as palliative treatment. PTBS was successfully performed in 55 patients who formed the PTBS group (failed in 2 patients). EBS was successfully performed in 52 patients who formed the EBS group (failed in 3 patients). The effectiveness of biliary drainage, hospital stay, complications, cost, survival time and mortality were compared.
  
  
  RESULTS
  Patients in PTBS group had shorter hospital stay and lower initial and overall expense than the BBS group (P < 0.05). There was no significant difference in effectiveness of biliary drainage (P = 0.9357) or survival time between two groups (P = 0.6733). Early complications occurred in PTBS group was significantly lower than in EBS group (3/55 vs 11/52, P = 0.0343). Late complications in the EBS group did not differ significantly from PTBS group (7/55 vs 9/52, P = 0.6922). The survival curves in the two groups showed no significant difference (P = 0.5294). Conclusions: 3.
authors.forename: Xin Rong
authors.initials: XR
authors.lastname: Sun
authors.forename: Cheng Wu
authors.initials: CW
authors.lastname: Tang
authors.forename: Wen Ming
authors.initials: WM
authors.lastname: Lu
authors.forename: Yong Qiang
authors.initials: YQ
authors.lastname: Xu
authors.forename: Wen Ming
authors.initials: WM
authors.lastname: Feng
authors.forename: Yin
authors.initials: Y
authors.lastname: Bao
authors.forename: Yin Yuan
authors.initials: YY
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000191:economics* / Q000295:instrumentation / Q000401:mortality; D002779:Cholestasis / Q000175:diagnosis / Q000191:economics* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D003362:Cost-Benefit Analysis; D004067:Digestive System Neoplasms / Q000150:complications* / Q000191:economics / Q000401:mortality; D004322:Drainage / Q000009:adverse effects / Q000191:economics* / Q000295:instrumentation / Q000401:mortality; D005260:Female; D017048:Health Care Costs; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000191:economics; D008297:Male; D008670:Metals / Q000191:economics; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics; D011474:Prosthesis Design; D015607:Stents / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals