کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3308325 1210400 2006 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Covered metal versus plastic stents for malignant common bile duct stenosis: a prospective, randomized, controlled trial
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های گوارشی
پیش نمایش صفحه اول مقاله
Covered metal versus plastic stents for malignant common bile duct stenosis: a prospective, randomized, controlled trial
چکیده انگلیسی

BackgroundMost patients with malignant common bile duct strictures are suited only for palliation of jaundice by placement of a polyethylene (PE) stent using an endoscopic retrograde cholangiographic technique. Occlusion of these stents occurs after 3 to 4 months, whereas uncovered self-expanding metal stents (SEMS) remain open twice as long. The initial higher cost of the latter might be balanced by a decreased need for repeat intervention.ObjectiveTo compare the patency of 10F PE stents and covered 30F steel SEMS (Wallstent; Boston Scientific Nordic AB, Helsingborg, Sweden).DesignSingle–center, prospective, randomized, controlled trial.SettingGeneral hospital in Stockholm, Sweden, which has a catchment area of 0.6 million people.PatientsNon-referred, unresectable malignant common bile duct strictures.InterventionsEndoscopic retrograde cholangiography with plastic stents or covered SEMS.Main Outcome MeasurementsTime to stent failure, requiring a new stent.LimitationsSimilar setting and patients, and costs in Scandinavia.ResultsFifty-one and 49 patients were allocated to the PE stent and SEMS groups, respectively. Fifty-six patients died without stent failure within 10 months (median, 2.6 months). Twenty-two PE stent and 9 SEMS patients (P = .009) developed failure after a median of 1.1 and 3.5 months, respectively (P = .007). Median patency times were 1.8 and 3.6 months in the PE and SEMS groups, respectively (P = .002). Median survival was 4.5 months; in 35 patients with distant metastases, the median survival was 2.5 months (P = .002)(PE group, 1.9 months).ConclusionsThe more-effective SEMS are recommended in unresectable patients with malignant common bile duct strictures, who survive a median of 4.5 months. Less costly plastic stents are preferable in the one third of patients who have distant metastases. In our study, the cost was equal.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Gastrointestinal Endoscopy - Volume 63, Issue 7, June 2006, Pages 986–995
نویسندگان
, ,