Percutaneous Transpapillary Placement of Biliary Metallic Stent in Patients with Malignant Extrahepatic Biliary Obstruction: Outcomes of Double-Bare Stent versus Polytetrafluoroethylene-Covered Stent

Objectives: To investigate the outcomes of percutaneous transpapillary placement of biliary metallic stent in patients with malignant extrahepatic biliary obstruction and to compare the outcomes of the uncovered double-bare stent and polytetrafluoroethylene (PTFE)-covered stent. Methods: From April 2015 to December 2018, 83 patients (50 men, 33 women; mean age, 64.3 years; age range, 36–89 years) with malignant extrahepatic biliary obstruction were enrolled in this retrospectively study. All patients underwent percutaneous transpapillary stent placement: uncovered double-bare stent placement in 40 patients and PTFE-covered stent placement in 43 patients. Results: There were no significant differences in technical success (P > 0.999), successful internal drainage (P = 0.473), complications (P = 0.217), patient survival (P = 0.107), and stent patency (P = 0.103) and between the two groups. Overall patient survival times were 90 days (95% confidence interval [CI], 30–150 days) in double-bare stent group and 219 days (95% CI, 99–339 days) in covered stent group, respectively. Stent occlusion occurred in seven patients (20%) at a mean of 114 days in double-bare stent group (food reflux with sludge [n = 5] and tumor ingrowth [n = 2]) and in 16 patients (41%) at a mean of 170 days in covered stent group (food reflux with sludge [n = 8], tumor overgrowth [n = 5], stent migration [n = 1], blood clot [n = 1], and stent collapse due to subsequent duodenal stenting [n = 1]) (P = 0.153). Median stent patency times were 74 days (95% CI, 47–101 days) in double-bare stent group and 135 days (95% CI, 55–139 days) in covered stent group, respectively. Conclusion: Percutaneous transpapillary placement of the biliary metallic stent seems to be effective and safe in patients with malignant extrahepatic biliary obstruction. Stent type may not significantly affect technical and clinical outcomes.

Publication History

Article published online:
26 April 2021