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Updated: Jul 6, 2025
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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
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Performance of biliary stents in malignant biliary strictures
Bartosz Ostrowski1, Tomasz Marek2, Aleksandra Janczewska3
1Department of Gastroenterology and Hepatology, K. Gibiński University Clinical Center, Medical University of Silesia, Katowice, Poland. bartoszostrowski8@gmail.com
Polish Archives of Internal Medicine
|January 2, 2024
Summary
Self-expandable metal stents (SEMSs) are more effective than plastic stents (PSs) for malignant biliary strictures, offering better bilirubin reduction, shorter hospital stays, and longer patency. SEMSs are the preferred choice for biliary drainage in these patients.
Area of Science:
- Gastroenterology
- Oncology
- Medical Devices
Background:
- Endoscopic stenting is a standard treatment for malignant biliary strictures.
- Both self-expandable metal stents (SEMSs) and plastic stents (PSs) are utilized.
Purpose of the Study:
- To compare the effectiveness of SEMSs versus PSs in endoscopic biliary drainage for malignant strictures.
- To optimize treatment strategies for malignant biliary strictures.
Main Methods:
- Retrospective analysis of 618 patients with malignant biliary strictures undergoing 1271 endoscopic retrograde cholangiopancreatography procedures with stenting (2012-2017).
- Minimum 3-year follow-up data derived from hospital database.
Main Results:
- SEMSs demonstrated a greater reduction in serum bilirubin compared to PSs (37% vs 32%, P=0.01).
- Hospital stay was significantly shorter with SEMSs (9.5 days vs 11.8 days, P<0.001).
- SEMSs showed longer patency (median 118 days vs 46 days, P<0.001), fewer complications (12.9% vs 19.3%, P=0.001), and were more cost-effective.
Conclusions:
- Self-expandable metal stents (SEMSs) significantly outperform plastic stents (PSs) in managing malignant biliary strictures.
- SEMSs are recommended as the treatment of choice for biliary drainage in patients with malignant biliary strictures.
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