Document Detail


A comparative evaluation of early stent occlusion among biliary conventional versus wing stents.
MedLine Citation:
PMID:  22262198     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND STUDY AIMS: Conventional plastic stents with a lumen typically have limited patency. The lumenless wing stent was engineered to overcome this problem. The objective of this study was to compare the incidence of early stent occlusion (symptomatic occlusion/cholangitis necessitating re-insertion within 90 days) for wing stents and conventional plastic stents.
PATIENTS AND METHODS: Patients with biliary pathology treated with plastic biliary stenting during the period 2003-2009 comprised the study cohort. Patients who had at least one biliary wing stent placed comprised the wing stent group, whereas patients who underwent only conventional stent plastic placement comprised the conventional stent group. Patients were stratified by indication: benign biliary strictures (group 1), malignant biliary strictures (group 2), or benign biliary non-stricture pathology (group 3). The association of stent type with the occurrence of primary outcome by indication was analyzed by use of multivariable logistic regression.
RESULTS: Three-hundred and forty-six patients underwent 612 ERCP procedures with placement of plastic biliary stent(s). On multivariate analysis, early stent occlusion did not differ between the wing and conventional groups in groups 1, 2, and 3. Among patients who achieved primary outcome in group 2, significantly fewer patients in the wing group had cholangitis (6.7% vs. 39.1%, P = 0.03). Among patients who achieved primary outcome in group 3, significantly fewer patients in the wing group had cholangitis (10% vs. 50%, P = 0.03).
CONCLUSIONS: Early stent occlusion was similar for wing stents and conventional plastic stents. Wing stents, however, were associated with a lower incidence of cholangitis in patients with malignant biliary obstruction and benign non-stricturing biliary pathology.
Authors:
Mouen A Khashab; Susan Hutfless; Katherine Kim; Anne Marie Lennon; Marcia I Canto; Sanjay B Jagannath; Patrick I Okolo; Eun Ji Shin; Vikesh K Singh
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2012-01-20
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  57     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-23     Completed Date:  2012-07-31     Revised Date:  2012-08-23    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1708-16     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA. mkhasha1@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Cholangiopancreatography, Endoscopic Retrograde / adverse effects*,  methods
Cholestasis / pathology,  radiography*,  therapy*
Cohort Studies
Constriction, Pathologic / epidemiology,  radiography
Female
Follow-Up Studies
Humans
Incidence
Logistic Models
Male
Multivariate Analysis
Prosthesis Design
Prosthesis Failure*
Retrospective Studies
Risk Assessment
Stents*
Treatment Outcome
Comments/Corrections
Comment In:
Dig Dis Sci. 2012 Jul;57(7):1975-6; author reply 1976   [PMID:  22623041 ]
Dig Dis Sci. 2012 Jul;57(7):1971; author reply 1971-2   [PMID:  22395960 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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