title: Comparison of covered and uncovered self-expandable stents in the treatment of malignant biliary obstruction.
abstract: OBJECTIVE
  Drainage with metallic stents is the treatment of choice in malignant obstructive jaundice. Technical and clinical success with metallic stents is obtained in over 90% and 80% of cases, respectively. There are self-expandable metallic stents designed to increase permeability. The aim of this study was to describe the results obtained with totally covered self-expandable and uncovered self-expandable metallic stents in the palliative treatment of malignant biliary obstruction.
  
  
  METHODS
  Sixty eight patients with malignant obstructive jaundice secondary to pancreatobiliary or metastatic disease not amenable to surgery were retrospectively included. Two groups were created: group A (covered self-expandable metallic stents) (n = 22) and group B (uncovered self-expandable metallic stents) (n = 46).
  
  
  RESULTS
  Serum total bilirubin, direct bilirubin, alkaline phosphatase and gamma glutamyl transferase levels decreased in both groups and no statistically significant difference was detected (p = 0.800, p = 0.190, p = 0.743, p = 0.521). Migration was greater with covered stents but it was not statistically significant either (p = 0.101). Obstruction was greater in the group with uncovered stents but it was not statistically significant either (p = 0.476).
  
  
  CONCLUSIONS
  There are no differences when using covered self-expandable stents or uncovered self-expandable stents in terms of technical and clinical success or complications in the palliative treatment of malignant obstructive jaundice.
authors.affiliation: Endoscopia Gastrointestinal, Instituto Nacional de Cancerología, MEXICO.
authors.forename: Diana Yamel
authors.initials: DY
authors.lastname: Flores Carmona
authors.affiliation: Endoscopia Gastrointestinal, Instituto Nacional de Cancerología, MEXICO.
authors.forename: Juan Octavio
authors.initials: JO
authors.lastname: Alonso Lárraga
authors.affiliation: Endoscopia Gastrointestinal, Instituto Nacional de Cancerología, MEXICO.
authors.forename: Angélica
authors.initials: A
authors.lastname: Hernández Guerrero
authors.affiliation: Endoscopia Gastrointestinal, Instituto Nacional de Cancerología, MEXICO.
authors.forename: Mauro Eduardo
authors.initials: ME
authors.lastname: Ramírez Solís
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications*; D002779:Cholestasis / Q000209:etiology / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D015607:Stents