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Pol. Arch. Med. Wewn. · Jan 2022
Performance of plastic stents used for benign and malignant biliary strictures; experience of single high-volume endoscopy unit.
- Bartosz Ostrowski, Tomasz Marek, Ewa Nowakowska-Duława, and Marek Hartleb.
- Department of Gastroenterology and Hepatology, Kornel Gibiński University Clinical Center, Medical University of Silesia in Katowice, Katowice, Poland. bartoszostrowski8@gmail.com
- Pol. Arch. Med. Wewn. 2022 Jan 28; 132 (1).
IntroductionEndoscopic plastic biliary stenting has been used for more than 30 years as a temporary or definitive treatment of benign and malignant neoplasms. These stents are commonly available, inexpensive, and easy to implant.ObjectivesWe aimed to evaluate the duration of plastic stent patency, to assess complications associated with stent use, and to determine the optimal timing of stent replacement depending on the indication for biliary stenting.Patients And MethodsThis was a retrospective cohort study with a 5‑year follow‑up including patients who underwent plastic biliary stent implantation between 2012 and 2013 in a tertiary referral gastroenterological center. The performance of stents was assessed on the basis of medical records, direct contact with patients or their family members, and information derived from the national death registry.ResultsWe assessed 830 biliary stenting procedures performed in 346 patients. The indications for biliary stenting included choledocholithiasis in 120 patients (34.7%), benign stricture in 70 patients (20.2%), and malignant stricture in 156 patients (45.1%). The mean duration of stent patency for these conditions was 110, 106, and 55 days, respectively (P <0.001). Stents implanted for malignant perihilar strictures had a shorter duration of patency than those used for distal strictures (40 days vs 76 days, P = 0.002).ConclusionsThe patency of plastic stents depends on the underlying disease. In patients with benign biliary disease, stent replacement is recommended after about 3.5 months. In patients with cancer, the timing of stent replacement should be guided by survival prognosis and location of stricture.
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