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Metallic or Plastic Stent for Bile Duct Obstruction in Ampullary Cancer?

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Abstract

Background and Aims

Although ampullary cancer is a relatively uncommon malignancy, it is frequently associated with biliary obstruction. Endoscopic biliary drainage is regarded as a palliative treatment of choice for patients with inoperable ampullary cancer. However, there are no data concerning choice of stent in this patient population. The objective of this study was to compare the efficacy of metallic and plastic stents for biliary obstruction in patients with ampullary cancer.

Methods

Thirty-seven patients (15 men and 22 women; median age 74.7 years) with ampullary cancer treated with endoscopic biliary drainage were enrolled. Metallic and two plastic stents were placed in 17 and 20 patients, respectively. Clinical success, stent patency, and stent malfunction were evaluated.

Results

Clinical success was achieved in all patients (100%). The median period of stent patency was 132.7 days in the metallic stent group and 128.5 days in the plastic stent group (P > 0.05). Stent malfunctions developed in 17 and 19 patients in the metallic and plastic stent groups, respectively. Stent occlusion occurred in 15 (88.2%) and 15 (75%) patients and stent migration occurred in two (11.8%) and four (20%) patients in the metallic and plastic stent groups, respectively.

Conclusions

Endoscopic biliary drainage using metallic or plastic stents is effective for initial endoscopic palliation in patients with obstructive jaundice because of ampullary cancer. Although metallic and plastic stents had similar clinical effect, it seems reasonable to choose two plastic stents as the first option in patients with ampullary cancer considering the cost-effectiveness.

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Acknowledgments

This study was supported by a grant from the Korea Healthcare technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (A091047).

Conflicts of interest

S. B. Park, H. W. Kim, D. H. Kang, C. W. Choi, J. H. Ryu, C. W. Chu, S. Y. Lee, Y. I. Jeong, H. J. Yeo, and E. J. Kim have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Internal Medicine, School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan Medical Centers, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 626-770, South Korea

    Su Bum Park, Hyung Wook Kim, Dae Hwan Kang, Cheol Woong Choi, Soo Yong Lee, Hye Ju Yeo & Eun Jung Kim

  2. Department of General Surgery, School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan Medical Centers, Yangsan, Korea

    Je Ho Ryu & Chong Woo Chu

  3. Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan Medical Centers, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 626-770, South Korea

    Young Il Jeong

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  1. Su Bum Park
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  2. Hyung Wook Kim
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  3. Dae Hwan Kang
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  4. Cheol Woong Choi
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  5. Je Ho Ryu
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  7. Soo Yong Lee
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  8. Young Il Jeong
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  9. Hye Ju Yeo
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  10. Eun Jung Kim
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Corresponding author

Correspondence to Dae Hwan Kang.

Additional information

Su Bum Park and Hyung Wook Kim contributed equally to this work.

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Park, S.B., Kim, H.W., Kang, D.H. et al. Metallic or Plastic Stent for Bile Duct Obstruction in Ampullary Cancer?. Dig Dis Sci 57, 786–790 (2012). https://doi.org/10.1007/s10620-011-1909-2

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  • DOI: https://doi.org/10.1007/s10620-011-1909-2

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