Related Experiment Video
Updated: May 15, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Metal versus plastic stents for malignant biliary obstruction: an update meta-analysis
Wan-dong Hong1, Xiao-wei Chen, Wen-Zhi Wu
1Department of Gastroenterology and Hepatology, the First Affiliated Hospital of Wenzhou Medical College, 2, Fu Xue Road, Wenzhou, 325000 Zhejiang, P.R. China.
Background And Objective:
The data on comparisons of stent patency, re-intervention rate and patient survival between metal and plastic stents in palliation of malignant biliary obstruction have never been pooled. We carry out a meta-analysis to summarise current evidence for clinical efficacy of metal and plastic stents in the treatment of malignant biliary obstruction.
Methods:
A comprehensive search of several databases was conducted. A fixed-effects or random-effects model was used to pool data of all study endpoints. Sensitivity analysis and subgroup analysis (distal vs. hilar biliary obstruction) were also performed.
Results:
Ten randomized clinical trials were identified. Compared with plastic stents, metal stents were associated with a significantly longer stent patency (HR=0.36; 95% CI: 0.28-0.47; I(2)=0%), fewer numbers of re-intervention (WMD=0.59; 95% CI: 0.28-0.90; I(2)=76.4%) and longer patient survival (HR=0.74; 95% CI: 0.64-0.85; I(2)=16.0%). These results were still significant by sensitivity analysis. All outcomes reached statistical significance except of the pooled WMD of number of re-intervention in the studies with hilar biliary obstruction. No publication bias was observed.
Conclusions:
Metal stents were associated with a significantly longer stent patency, lower re-intervention rate and longer patient survival in palliation of malignant biliary obstruction when compared to plastic stents.
