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Wallstents versus plastic stents in malignant biliary obstruction: effects of stent patency of the first and second stent on patient compliance and survival

Wallstents versus plastic stents in malignant biliary obstruction: effects of stent patency of the first and second stent on patient compliance and survival

Authors :
A, Schmassmann
E, von Gunten
J, Knuchel
U, Scheurer
H F, Fehr
F, Halter
Source :
The American journal of gastroenterology. 91(4)
Publication Year :
1996

Abstract

In prospective trials in patients with malignant biliary obstruction, it has been reported that Wallstents prolong stent patency, but this does not translate into a significant survival benefit. Compared with prospective trials, however, survival may be different in clinical practice because of differences in patient compliance. We report on a retrospective, long term analysis comparing Wallstents versus plastic stents.Plastic endoprostheses (70 patients) and endoscopic Wallstents (95 patients) were placed in 165 consecutive patients with irresectable, malignant biliary obstruction in a first (1990-91) and second (1992-93) time period. Stent occlusion was treated by plastic stent placement.Patient characteristics were quite comparable in both stent groups. Initial placement of a Wallstent resulted in an increase of median stent patency of the first (10 vs 4 months, p0.001) and second (8 vs 3 months, p0.05) stent, a decrease of additional endoscopic procedures (20 vs 58%, p0.005), an increase of patient compliance reflected by a decrease of patients dying with untreated stent occlusion (9 vs 30%, p0.001), and an increase of survival time (6.5 vs 4 months, p0.05).Initial placement of a Wallstent results in an increase of stent patency of the first and second stent. Duration of stent patency appears to have a determinant effect on patient compliance. Increased stent patency and patient compliance seem to improve survival in clinical practice.

Details

ISSN :
00029270
Volume :
91
Issue :
4
Database :
OpenAIRE
Journal :
The American journal of gastroenterology
Accession number :
edsair.pmid..........38422eb2853cc7c575da3927e550327b