PMID- 23591331
OWN - NLM
STAT- MEDLINE
DCOM- 20140310
LR  - 20230202
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 78
IP  - 2
DP  - 2013 Aug
TI  - Comparison of the utility of covered metal stents versus uncovered metal stents 
      in the management of malignant biliary strictures in 749 patients.
PG  - 312-24
LID - S0016-5107(13)00192-2 [pii]
LID - 10.1016/j.gie.2013.02.032 [doi]
AB  - BACKGROUND: Self-expandable metal stents (SEMSs) are used to relieve malignant 
      biliary obstruction. OBJECTIVE: To compare outcomes between covered 
      self-expandable metal stents (CSEMSs) and uncovered self-expandable metal stents 
      (USEMSs) in malignant biliary obstruction. DESIGN: Retrospective cohort study. 
      SETTING: Tertiary cancer center. PATIENTS: Patients with malignant biliary 
      obstruction. INTERVENTIONS: Placement of CSEMS or USEMS. MAIN OUTCOME 
      MEASUREMENTS: Time to recurrent biliary obstruction (TRO), overall survival (OS), 
      and adverse events. RESULTS: From January 2000 to June 2011, 749 patients 
      received SEMSs: 171 CSEMSs and 578 USEMSs. At 1 year, there was no significant 
      difference in the percentage of patients with recurrent obstruction (CSEMSs, 35% 
      vs USEMSs, 38%) and survival (CSEMSs, 45% vs USEMSs, 49%). There was no 
      significant difference in the median OS (CSEMSs, 10.4 months vs USEMSs, 11.8 
      months; P = .84) and the median TRO (CSEMSs, 15.4 months vs USEMSs, 26.3 months; 
      P = .61). The adverse event rate was 27.5% for the CSEMS group and 27.7% for the 
      USEMS group. Although tumor ingrowth with recurrent obstruction was more common 
      in the USEMS group (76% vs 9%, P < .001), stent migration (36% vs 2%, P < .001) 
      and acute pancreatitis (6% vs 1%, P < .001) were more common in the CSEMS group. 
      LIMITATIONS: Retrospective study. CONCLUSIONS: There was no significant 
      difference in the patency rate or overall survival between CSEMSs and USEMSs for 
      malignant distal biliary strictures. The CSEMS group had a significantly higher 
      rate of migration and pancreatitis than the USEMS group. No significant 
      SEMS-related adverse events were observed in patients undergoing neoadjuvant 
      chemoradiation or surgical resection.
CI  - Copyright (c) 2013 American Society for Gastrointestinal Endoscopy. Published by 
      Mosby, Inc. All rights reserved.
FAU - Lee, Jeffrey H
AU  - Lee JH
AD  - Department of Gastroenterology, Hepatology, and Nutrition, The University of 
      Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. 
      jefflee@mdanderson.org
FAU - Krishna, Somashekar G
AU  - Krishna SG
FAU - Singh, Amanpal
AU  - Singh A
FAU - Ladha, Harshad S
AU  - Ladha HS
FAU - Slack, Rebecca S
AU  - Slack RS
FAU - Ramireddy, Srinivas
AU  - Ramireddy S
FAU - Raju, Gottumukkala S
AU  - Raju GS
FAU - Davila, Marta
AU  - Davila M
FAU - Ross, William A
AU  - Ross WA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20130413
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
RN  - 0 (Metals)
SB  - IM
MH  - Aged
MH  - Cholangiopancreatography, Endoscopic Retrograde/*instrumentation
MH  - Cholestasis/etiology/*therapy
MH  - Cohort Studies
MH  - Disease-Free Survival
MH  - Equipment Design
MH  - Equipment Failure
MH  - Female
MH  - Humans
MH  - Male
MH  - Metals
MH  - Middle Aged
MH  - Pancreatic Neoplasms/*complications
MH  - Recurrence
MH  - Retrospective Studies
MH  - *Stents
MH  - Treatment Outcome
OTO - NOTNLM
OT  - CSEMS
OT  - OS
OT  - ROFS
OT  - SE
OT  - SEMS
OT  - TRO
OT  - USEMS
OT  - covered self-expandable metal stent
OT  - overall survival
OT  - recurrent obstruction-free survival
OT  - self-expandable metal stent
OT  - standard error
OT  - time to recurrent biliary obstruction
OT  - uncovered self-expandable metal stent
EDAT- 2013/04/18 06:00
MHDA- 2014/03/13 06:00
CRDT- 2013/04/18 06:00
PHST- 2012/09/25 00:00 [received]
PHST- 2013/02/22 00:00 [accepted]
PHST- 2013/04/18 06:00 [entrez]
PHST- 2013/04/18 06:00 [pubmed]
PHST- 2014/03/13 06:00 [medline]
AID - S0016-5107(13)00192-2 [pii]
AID - 10.1016/j.gie.2013.02.032 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2013 Aug;78(2):312-24. doi: 10.1016/j.gie.2013.02.032. Epub 
      2013 Apr 13.