OBJECTIVES: 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. METHODS: 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. RESULTS: 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, p < 0.001) and second (8 vs 3 months, p < 0.05) stent, a decrease of additional endoscopic procedures (20 vs 58%, p < 0.005), an increase of patient compliance reflected by a decrease of patients dying with untreated stent occlusion (9 vs 30%, p < 0.001), and an increase of survival time (6.5 vs 4 months, p < 0.05). CONCLUSIONS: 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.
OBJECTIVES: 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. METHODS: 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. RESULTS: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, p < 0.001) and second (8 vs 3 months, p < 0.05) stent, a decrease of additional endoscopic procedures (20 vs 58%, p < 0.005), an increase of patient compliance reflected by a decrease of patients dying with untreated stent occlusion (9 vs 30%, p < 0.001), and an increase of survival time (6.5 vs 4 months, p < 0.05). CONCLUSIONS: 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.
Authors: Rodrigo Castaño; Tercio L Lopes; Oscar Alvarez; Victor Calvo; Leticia P Luz; Everson L A Artifon Journal: Surg Endosc Date: 2010-02-21 Impact factor: 4.584
Authors: B A Radeleff; R López-Benítez; P Hallscheidt; L Grenacher; M Libicher; G M Richter; G W Kauffmann Journal: Radiologe Date: 2005-11 Impact factor: 0.635
Authors: Peter L Moses; Khalid M Alnaamani; Alan N Barkun; Stuart R Gordon; Roger D Mitty; M Stanley Branch; Thomas E Kowalski; Myriam Martel; Viviane Adam Journal: World J Gastroenterol Date: 2013-12-14 Impact factor: 5.742
Authors: Gregory A Coté; Michael Ansstas; Somal Shah; Rajesh N Keswani; Saad Alkade; Sreenivasa S Jonnalagadda; Steven A Edmundowicz; Riad R Azar Journal: Surg Endosc Date: 2009-12-30 Impact factor: 4.584
Authors: C P Neal; S C Thomasset; D Bools; C D Sutton; G Garcea; C D Mann; Y Rees; C Newland; R J Robinson; A R Dennison; D P Berry Journal: Surg Endosc Date: 2009-06-30 Impact factor: 4.584