title: [Cost-effectiveness trial of self-expandable metal stents and plastic biliary stents in malignant biliary obstruction].
abstract: BACKGROUND
  Self-expandable metal and plastic stents can be applied in the palliative endoscopic treatment of patients with unresectable malignant biliary obstruction. The use of metal stentsis recommended if the patient's life expectancy is more than four months.
  
  
  OBJECTIVE
  To compare the therapeutic efficacy and cost-effectiveness of metal and plastic stents in the treatment of malignant biliary obstruction.
  
  
  METHODS
  The authors retrospectively enrolled patients who received metal (37 patients) or plastic stent (37 patients). The complication rate, stent patency and cumulative cost of treatment were assessed in the two groups.
  
  
  RESULTS
  The complication rate of metal stents was lower (37.84% vs. 56.76%), but the stent patency was higher compared with plastic stents (19.11 vs. 8.29 weeks; p = 0.0041). In the plastic stent group the frequency of hospitalization of patients in context with stent complications (1.18 vs. 2.32; p = 0.05) and the necessity of reintervention for stent dysfunction (17 vs. 27; p = 0.033) were substantially higher. In this group multiple stent implantation raised the stent patency from 7.68 to 10.75 weeks. There was no difference in the total cost of treatment of malignant biliary obstruction between the two groups (p = 0.848).
  
  
  CONCLUSIONS
  Considering the cost of treatment and the burden of patients the authors recommend self-expandable metal sten timplantation if the life expectancy of patients is more than two months. In short survival cases multiple plastic stent implantation is recommended.
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: Tímea
authors: T
authors: Daróczi
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: Renáta
authors: R
authors: Bor
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: Anna
authors: A
authors: Fábián
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: Ella
authors: E
authors: Szabó
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: Klaudia
authors: K
authors: Farkas
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: Anita
authors: A
authors: Bálint
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: László
authors: L
authors: Czakó
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: Mariann
authors: M
authors: Rutka
authors: Orvosi Fizika és Orvosi Informatika Intézet, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged.
authors: Mónika
authors: M
authors: Szűcs
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: Ágnes
authors: Á
authors: Milassin
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: Tamás
authors: T
authors: Molnár
authors: I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8-10., 6720.
authors: Zoltán
authors: Z
authors: Szepes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000150:complications*; D001662:Biliary Tract Surgical Procedures / Q000191:economics* / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D006814:Hungary; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000191:economics / Q000379:methods; D010969:Plastics; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents / Q000191:economics*; D015607:Stents / Q000191:economics*
chemical_list: D010969:Plastics
keywords: biliary obstruction; biliary plastic stent; endoscopic retrograde cholangiopancreatography; endoszkópos retrográd cholangiopancreatographia; epeúti fémstent; epeúti műanyag stent; epeúti obstrukció; pancreascarcinoma; pancreatic cancer; self-expandable biliary metal stent