Antireflux Versus Conventional Plastic Stent in Malignant Biliary Obstruction: A Prospective Randomized Study

J Laparoendosc Adv Surg Tech A. 2017 Jan;27(1):53-57. doi: 10.1089/lap.2016.0178. Epub 2016 Oct 18.

Abstract

Objective: Endoscopic stents are used to relieve obstructive jaundice. The purpose of this prospective randomized study was to compare the patency of antireflux and conventional plastic biliary stent in relieving distal malignant biliary obstruction.

Materials and methods: All jaundiced patients admitted to hospital with suspected unresectable malignant distal biliary stricture between October 2009 and September 2010 were evaluated for the study. Eligible patients were randomized either to antireflux or conventional plastic stent arms. The primary endpoint was stent patency and the follow-up was continued either until the stent was occluded or until 6 months after the stent placement.

Results: At an interim analysis, antireflux stents (ARSs; n = 6) had a significantly shorter median patency of 34 (8-49) days compared with the conventional stent (n = 7) patency of 167 (38-214) days (P = .0003). Based on these results, the study was terminated due to ethical concerns.

Conclusion: According to these results, the use of this ARS is not recommended.

Keywords: ERCP; antireflux stent; distal biliary obstruction; plastic stent; stent patency.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cholestasis / etiology
  • Cholestasis / therapy*
  • Early Termination of Clinical Trials
  • Female
  • Humans
  • Jaundice, Obstructive / etiology
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Plastics
  • Prospective Studies
  • Prosthesis Failure*
  • Stents* / adverse effects
  • Time Factors

Substances

  • Plastics