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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
- 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