Are self-expandable metal stents superior to plastic stents in palliating malignant distal biliary strictures? A meta-analysis and systematic review |
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| Institution: | 1. Clinical Associate (Internal Medicine), University of Illinois College of Medicine at Peoria, Peoria, IL, USA;2. Clinical Gastroenterologist (Gastroenterology and Hepatology), University of Illinois College of Medicine at Peoria, Peoria, IL, USA;3. Clinical Gastroenterologist (Gastroenterology and Hepatology), University of Missouri, Columbia, MI, USA;1. Departments of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul, 138-736, Republic of Korea;2. Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul, 138-736, Republic of Korea;3. Internal Medicine, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul, 138-736, Republic of Korea;4. Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul, 138-736, Republic of Korea.;1. Department of Radiology, Hanoi Medical University Hospital, Hanoi, Vietnam;2. Department of Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam;3. Department of Diagnostic Radiology, Keio University, Tokyo, Japan;4. Department of Respiratory Medicine, Hanoi French Hospital, 1 Phuong Mai St., Dong Da District, 10000 Hanoi, Vietnam;1. Professor & Head, Department of Internal Medicine, Armed Forces Medical College, Pune 411040, India;2. Assistant Professor (Medicine), Command Hospital (Southern Command), Pune 411040, India;3. Resident, Department of Medicine, Armed Forces Medical College, Pune 411040, India;4. Assistant Professor, Department of Medicine, Armed Forces Medical College, Pune 411040, India;5. Associate Professor, Department of Medicine, Armed Forces Medical College, Pune 411040, India;6. Professor & Head, Department of Geriatric Medicine, Armed Forces Medical College, Pune 411040, India;1. Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, 2301 Erwin Road, 27710 Durham, NC, USA;2. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1037 Luoyu Road, Wuhan, China;3. Division of Gastroenterology, Department of Medicine, Duke University Medical Center, 2301 Erwin Road, 27710 Durham, NC, USA;1. Consultant (Obst and Gynae), Base Hospital, Delhi Cantt 110001, India;2. Classified Specialist (Obst and Gynae), Military Hospital, Allahabad, India;3. Classified Specialist (Radiodiagnosis), Military Hospital, Allahabad, India |
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| Abstract: | BackgroundPalliation for inoperable malignant distal biliary strictures can be achieved with self-expandable metal stents (SEMS) and plastic stents (PS). This is a meta-analysis to compare PS and SEMS. The aim of the study is to compare clinical outcomes in patients with SEMS and PS.MethodsStudy selection criteria were studied using SEMS and PS for palliation in patients with malignant distal biliary stricture. For data collection and extraction, articles were searched in Ovid journals, Medline, Cochrane database, and Pubmed. Pooled proportions were calculated using both Mantel–Haenszel method and DerSimonian Laird method for statistical analysis.ResultsInitial search identified 1376 reference articles, of which 112 were selected and11 studies (N = 947) were included in this analysis. Pooled analysis showed SEMS patency to be 167.7days (95% CI = 159.2–176.3) compared to 73.3days (95% CI = 69.8–76.9) in PS. SEMS have lower odds of occlusion when compared to PS with an odds ratio of 0.48 (95% CI = 0.34–0.67). SEMS has a lower odds of cholangitis compared to SP, with an odds ratio of 0.46 (95% CI = 0.30–0.69).ConclusionSEMS seem to be superior to PS with better patency periods and survival duration. SEMS have lower occlusion rates, re-intervention rates, and cholangitis. |
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| Keywords: | Self-expandable metal stents Plastic stents Malignant distal biliary stricture |
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