Common Bile Duct Obstruction Due to Malignancy: Treatment With Plastic Versus Metal Stents

Radiology. 1996 Oct;201(1):167-72. doi: 10.1148/radiology.201.1.8816539.

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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cholestasis, Extrahepatic / etiology
  • Cholestasis, Extrahepatic / mortality
  • Cholestasis, Extrahepatic / therapy*
  • Common Bile Duct Diseases / etiology
  • Common Bile Duct Diseases / mortality
  • Common Bile Duct Diseases / therapy*
  • Cost-Benefit Analysis
  • Digestive System Neoplasms / complications
  • Female
  • Follow-Up Studies
  • Health Care Costs
  • Humans
  • Length of Stay / economics
  • Male
  • Plastics*
  • Prospective Studies
  • Risk Factors
  • Stainless Steel*
  • Stents* / economics
  • Survival Rate
  • Time Factors

Substances

  • Plastics
  • Stainless Steel