Abstract
Background
Currently, the percutaneous approach is the mainstream of treatment for malignant bilioenteric anastomotic stricture (BAS). However, there is no consensus on the optimal bile drainage method since previous studies on malignant BAS related jaundice are very limited. The purpose of the study is to compare self-expandable metallic stent placement with catheter drainage for malignant bilioenteric anastomotic stricture in terms of efficacy and safety.
Materials and Methods
This study included 54 patients with malignant bilioenteric anastomotic stricture treated from March 2016 to February 2020. Twenty-seven patients underwent insertion of self-expandable metallic stent (Stent group); the remaining twenty-seven patients underwent internal-external catheter drainage (Catheter group). Technical success was defined as successful placement of stent or drainage catheter in the appropriate position; clinical success was defined as a 20% reduction in serum bilirubin within 1 week after the procedure, compared with baseline. Complications, duration to stent/catheter malfunction, and overall survival were evaluated.
Results
Technical success was achieved in all patients in both groups. In the Stent group, 21 patients received one stent and the other 6 patients required two stents. Clinical success rates were similar between the groups (Stent group, 92.6% [25/27]; Control group, 88.9% [24/27]). There were no major complications. The median duration to stent/catheter malfunction was significantly longer in the Stent group (130 days) than in the Control group (82 days; P = 0.010). The median overall survival was also significantly longer in the Stent group (187 days) than in the Catheter group (118 days; P = 0.038).
Conclusion
Self-expandable metallic stent placement may be better than internal-external catheter drainage for malignant bilioenteric anastomotic stricture in terms of the duration before stent/catheter malfunction and patient survival.
Metallic stent placement versus catheter drainage for malignant bilioenteric anastomotic stricture
