A randomized trial comparing winged versus conventional plastic stents for malignant bile duct strictures

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Oncology

Background:

• Endoscopic retrograde cholangiopancreatography (ERCP) is standard for malignant biliary obstruction.
• Conventional plastic stents have limited patency.
• Winged stents may offer improved patency duration.

Purpose of the Study:

• To compare the stent patency of winged versus conventional plastic stents.
• To evaluate the efficacy of winged stents in managing malignant biliary obstruction.

Main Methods:

• Prospective, randomized, subject-blinded trial.
• 49 patients with malignant biliary obstruction randomized to winged (n=23) or conventional (n=26) plastic stents.
• Clinical follow-up to determine stent failure until surgery, death, or study closure.

Main Results:

• Median time to stent failure was 89 days for winged vs. 143 days for conventional stents (P=0.963).
• Stent failure rates were 48% for winged and 54% for conventional stents.
• Median survival was 123 days for winged vs. 342 days for conventional stents (P=0.084).
• No procedure-related adverse events were reported.

Conclusions:

• Winged plastic stents did not demonstrate improved stent patency compared to conventional plastic stents.
• Current evidence does not support the use of winged stents over conventional stents for malignant biliary obstruction.