Outcomes of percutaneous metallic stenting for malignant bilioenterostomy stricture: a retrospective single-center study of 368 patients.
To evaluate the technical and clinical outcomes of percutaneous metallic stenting in patients with malignant bilioenterostomy obstruction and to identify risk factors affecting stent patency.
This retrospective study included 368 patients (240 men, 128 women; mean age, 68.2 years; range, 39-95 years) who underwent percutaneous biliary metallic stent placement between March 2012 and November 2023. Patients were categorized into three groups based on stent type: covered, single uncovered, and double uncovered.
Technical success was achieved in all patients. Uncovered stents-single uncovered (n = 208; 56.5%) and double uncovered (n = 50; 13.6%)-were placed in 70.1% of patients, while covered stents were used in 29.9%. Major and minor complication rates were 1.1% and 1.9%. Successful internal drainage, defined as removal of the temporary drainage catheter, was achieved in 87.8% of patients. Median survival and stent patency times were 241 days (95% CI, 216-266) and 255 days (95% CI, 194.7-315.3). No significant factors were associated with overall survival. Stent occlusion occurred in 50.5% of patients, most commonly due to tumor ingrowth (74.3%). On multivariate Cox regression, double uncovered stent placement (HR, 0.440; 95% CI, 0.295-0.656; p < 0.001), covered stent placement (HR, 0.301; 95% CI, 0.161-0.564; p < 0.001), and post-stenting serum bilirubin < 2.0 mg/dL (HR, 0.715; 95% CI, 0.517-0.990; p = 0.043) were independent predictors of prolonged stent patency.
Percutaneous metallic stenting is a safe and effective treatment for malignant bilioenterostomy obstruction. Covered and double-uncovered stents are associated with longer stent patency.
Question: What are the technical and clinical outcomes of percutaneous metallic stenting in malignant bilioenterostomy obstruction, and which factors affect stent patency?
Covered and double-uncovered stents showed significantly longer patency. Stent type and bilirubin < 2.0 mg/dL were independent predictors of patency.
Percutaneous metallic stenting is safe and effective for malignant bilioenterostomy obstruction. Covered and double uncovered stents prolong patency, supporting their use as preferred options to improve long-term biliary drainage and patient outcomes.
This retrospective study included 368 patients (240 men, 128 women; mean age, 68.2 years; range, 39-95 years) who underwent percutaneous biliary metallic stent placement between March 2012 and November 2023. Patients were categorized into three groups based on stent type: covered, single uncovered, and double uncovered.
Technical success was achieved in all patients. Uncovered stents-single uncovered (n = 208; 56.5%) and double uncovered (n = 50; 13.6%)-were placed in 70.1% of patients, while covered stents were used in 29.9%. Major and minor complication rates were 1.1% and 1.9%. Successful internal drainage, defined as removal of the temporary drainage catheter, was achieved in 87.8% of patients. Median survival and stent patency times were 241 days (95% CI, 216-266) and 255 days (95% CI, 194.7-315.3). No significant factors were associated with overall survival. Stent occlusion occurred in 50.5% of patients, most commonly due to tumor ingrowth (74.3%). On multivariate Cox regression, double uncovered stent placement (HR, 0.440; 95% CI, 0.295-0.656; p < 0.001), covered stent placement (HR, 0.301; 95% CI, 0.161-0.564; p < 0.001), and post-stenting serum bilirubin < 2.0 mg/dL (HR, 0.715; 95% CI, 0.517-0.990; p = 0.043) were independent predictors of prolonged stent patency.
Percutaneous metallic stenting is a safe and effective treatment for malignant bilioenterostomy obstruction. Covered and double-uncovered stents are associated with longer stent patency.
Question: What are the technical and clinical outcomes of percutaneous metallic stenting in malignant bilioenterostomy obstruction, and which factors affect stent patency?
Covered and double-uncovered stents showed significantly longer patency. Stent type and bilirubin < 2.0 mg/dL were independent predictors of patency.
Percutaneous metallic stenting is safe and effective for malignant bilioenterostomy obstruction. Covered and double uncovered stents prolong patency, supporting their use as preferred options to improve long-term biliary drainage and patient outcomes.