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Radiology. 1996 Oct;201(1):167-72.

Common bile duct obstruction due to malignancy: treatment with plastic versus metal stents.

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1
Department of Angiography and Interventional Radiology, University of Vienna, Austria.

Abstract

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.

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