Common bile duct obstruction due to malignancy: treatment with plastic versus metal stents.
| Autor: | Lammer J; Department of Angiography and Interventional Radiology, University of Vienna, Austria., Hausegger KA, Flückiger F, Winkelbauer FW, Wildling R, Klein GE, Thurnher SA, Havelec L |
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| Jazyk: | angličtina |
| Zdroj: | Radiology [Radiology] 1996 Oct; Vol. 201 (1), pp. 167-72. |
| DOI: | 10.1148/radiology.201.1.8816539 |
| Abstrakt: | Purpose: To compare the clinical efficacy and treatment costs of plastic versus metal biliary stents. Materials and Methods: In a randomized trial, 101 patients with malignant common bile duct obstruction underwent transhepatic stent implantation and were followed up until death. Patients were stratified into risk and nonrisk groups. Forty-nine patients received 12-F plastic stents, and 52 received expandable metal stents. Plastic endoprostheses were placed in a two-step procedure; metal stent, in a single procedure. Kaplan-Meier analyses were used to compare patient survival and stent patency rates. Results: The 30-day mortality rate was significantly lower for metal stents (five of 52 [10%]) than plastic stents (12 of 49 [24%]; P = .05). The obstruction rate was 19% (10 of 52; median patency, 272 days) for metal stents and 27% for plastic stents (13 of 49; median patency, 96 days; P < .01). Median time until death or obstruction was longer for metal stents (122 vs 81 days; P < .01). Placement of metal stents was associated with shorter hospital stay (10 vs 21 days; P < .01) and lower cost ($7,542 vs $12,129; P < .01). Conclusion: Use of self-expanding metal stents appears to show substantial benefits for patients and to be cost-effective. |
| Databáze: | MEDLINE |
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