Jae-Yeon Hwang, Presenter: Nothing to Disclose

Dong Il Gwon, Abstract Co-Author: Nothing to Disclose

Gi-Young Ko MD, Abstract Co-Author: Nothing to Disclose

Hyun-Ki Yoon, Abstract Co-Author: Nothing to Disclose

Jin Hyoung Kim MD, Abstract Co-Author: Nothing to Disclose

Im Sick Lee BS, Abstract Co-Author: Nothing to Disclose

Kyung-Ah Kim RN, Abstract Co-Author: Nothing to Disclose

Kyu-Bo Sung MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To investigate our results with covered versus uncovered stent placement in the treatment of distal malignant biliary obstructions.

One hundred seventeen consecutive patients with unresectable distal biliary malignancies (lymph node metastases [n=38], pancreas carcinoma [n=35], bile duct carcinoma [n=28], gallbladder carcinoma [n=11], ampulla of Vater carcinoma [n=3], duodenum carcinoma [n=2]) were enrolled. PTFE (polytetrafluoroethylene)-covered stents were used in 59 patients and uncovered stents in 58 patients.

During the mean follow-up period of 186 days (range, 16—694 days), stent occlusion occurred in five (8.5%) patients in the covered group and in nineteen patients (32.8%) in the uncovered group. The cumulative stent patency of covered stents (median, 545 days; 95% CI, 458—631 days) was statistically higher than that of uncovered stents (median, 403 days; 95% CI, 311—496 days) (p=0.026). There was no statistical difference in survival between the two stent groups. In subgroup analysis according to underlying malignancies, there was no statistical difference in cumulative stent patency between the two stent groups in each malignancy. The cumulative stent patency of lymph node metastases group (median, 561 days; 95% CI, 466—656 days) was statistically higher than other groups (median, 414 days; 95% CI, 327—501 days) including pancreas carcinoma, bile duct carcinoma, gallbladder carcinoma, and ampulla of Vater carcinoma, and duodenal carcinoma (p=0.04). There was no statistical difference in survival between lymph node metastases group and other groups. Stent migration occurred in two of the covered group and in none of the uncovered group. Acute cholecystitis occurred in one of the covered group and in none of the uncovered group.

PTFE-covered stents were significantly superior to uncovered stents for the treatment of distal malignant biliary obstructions. Furthermore, metallic stent placement was most effective in patients with distal malignant biliary obstructions caused by lymph node metastases.

PTFE-covered stent is more effective compared to uncovered stent in treatment of patients with unresectable distal biliary malignant obstruction.

Hwang, J, Gwon, D, Ko, G, Yoon, H, Kim, J, Lee, I, Kim, K, Sung, K, et al, 0, A Comparison of Percutaneously Placed Covered and Uncovered Stents for Treatment of Distal Malignant Biliary Obstructions: Is Covered Stent Placement Superior to Uncovered Stent Placement?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8010888.html