It is clear that metal stents are superior to plastic stents for palliation of distal malignant biliary obstruction (dMBO). Among self-expanding metal stents (SEMS), there are 3 choices: uncovered SEMS (UCSEMS), partially covered SEMS (PCSEMS), and fully covered SEMS (FCSEMS). UCSEMS have a higher risk of tissue\/tumor ingrowth than FCSEMS but a lower risk of migration. Moreover, FCSEMS can be removed if stent occlusion occurs and replaced with a new stent (rather than needing to place a second coaxial stent).<\/p>\n\n\n\n
In this study by Ghazi et al, the investigators retrospectively evaluated a large cohort of patients with clinical follow-up who underwent ERCP for dMBO (82.6% pancreatic adenocarcinoma), comparing the outcomes of FCSEMS (n=90) and UCSEMS (n=364). The median duration of follow-up was 9.6 months.<\/p>\n\n\n\n
Clinical success, defined as a reduction in serum bilirubin of 33% by one week or 50% by two weeks, was similar between UCSEMS (89.3%) and FCSEMS (93.3%; P<\/em>=.25). There was a higher percentage of adverse events in the UCSEMS group versus FCSEMS group overall (33.5% vs 21.1%; P<\/em>=.02), though a large proportion of this was due to tissue ingrowth (26.9% vs 8.9%; P<\/em><.001) in the USCSEMS group. The authors found a higher proportion of stent migrations in the FCSEMS group (7.8% vs 1.1%, P<\/em><.001); however, there were no statistically significant differences in the rates of other adverse events, such as post-ERCP pancreatitis, cholecystitis, bleeding, perforation, and stent misdeployment, between both groups.<\/p>\n\n\n\n The UCSEMS group had a higher rate of unplanned reintervention (27.0% vs 11.1%; P<\/em>=.002) and a shorter time to reintervention (4.4 months vs 7.6 months; P<\/em>=.04), both of which were likely due to the higher rates of stent occlusion noted in the UCSEMS group.<\/p>\n\n\n\n <\/p>\n\n\n\n <\/p>\n","protected":false},"excerpt":{"rendered":" It is clear that metal stents are superior to plastic stents for palliation of distal malignant biliary obstruction (dMBO). Among self-expanding metal stents (SEMS), there are 3 choices: uncovered SEMS (UCSEMS), partially covered SEMS (PCSEMS), and fully covered SEMS (FCSEMS). UCSEMS have a higher risk of tissue\/tumor ingrowth than FCSEMS but a lower risk of … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,67],"tags":[3759,2086,3758,3753,2128,3756,3757,3755,3754],"class_list":["post-14265","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-bauchspeicheldruese-pankreas","tag-dmbo","tag-fcsems","tag-fully-covered-sems","tag-metal-stents-2","tag-pancreatobiliary","tag-partially-covered-sems","tag-pcsems","tag-ucsems","tag-uncovered-sems"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/14265","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=14265"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=14265"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=14265"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}