Affiliation:
1. General hospital of Northern Theater Command
2. First affiliated Hospital of Dalian Medical University
Abstract
Abstract
Objective
To compare the efficacy of fully covered and uncovered self-expandable metallic stents in patients with inoperable malignant distal biliary obstruction.
Methods
A retrospective study was performed in 310 patients with inoperable malignant distal biliary obstruction from January 2017 to December 2021. Among these, 75 patients received fully-covered self-expandable metallic stent (FCSEMS) implantations while 235 received uncovered stent (USEMS) implantations. All patients were pathologically diagnosed. Overall survival, stent patency, and postoperative complications were evaluated and analyzed.
Results
No significant difference was found between the FCSEMS and USEMS groups in terms of overall survival time (167 vs. 169 days, P = 0.566). However, the mean stent patency duration in the FCSEMS group was longer than that in the USEMS(445 vs. 348 days, P = 0.020) group. No remarkable differences were found in postoperative complications, including acute pancreatitis, cholecystitis, cholangitis, stent migration, occlusion, and postoperative bleeding, between the two groups. A multivariate analysis indicated that EST (HR = 1.259, 95% CI [1.167–1.358], P < 0.001), USEMS(HR = 2.277, 95%CI [1.750–2.963], P < 0.001), stent length (HR = 1.804, 95% CI [1.662–1.959], P < 0.001), pre-operative biliary stent (HR = 1.166, 95% CI [1.070–1.271], P < 0.001) and non-pancreatic cancer (HR1.404, 95% CI [1.299–1.516], P < 0.001) were independent risk factors for stent occlusion, while a BMI of > 24 kg/m2 (HR0.600, 95%CI[0.548–0.657], P < 0.001) was a protective factor.
Conclusions
Compared to USEMS, FCSEMS could offer a longer stent patency time for patients with DMBO; however, no significant difference was found in overall survival and postoperative complications in our retrospective study.
Publisher
Research Square Platform LLC