2019
Efficacy of Different Endoscopic Stents in the Management of Postoperative Biliary Strictures A Systematic Review and Meta-analysis
Publication
Publication
Journal of Clinical Gastroenterology , Volume 53 - Issue 6 p. 418- 426
Background:
Endoscopic stents are the first-line treatment in the
management of benign biliary stricture (BBS) which include multiple plastic stents (MPSs), fully covered self-expandable metal
stents (FCSEMS) including the conventional and modified ones
(FCSEMS-C and FCSEMS-M) and biodegradable stents. However,
different stents have their distinct advantages and disadvantages.
We aim to conduct this systematic review to compare the efficacy of
different stents in the management of BBS.
Methods:
Several databases were searched from inception through
March 2018. Studies including >10 patients with postoperative
stricture treated with endoscopic stents were enrolled. Pooled odds
ratio of outcomes were calculated to compare MPS with FCSEMS.
Weighted pooled rates were calculated to show the efficacy of
FCSEMS-M, FCSEMS-C, and MPS.
Results:
Twenty-two articles were reviewed including 4 randomized
controlled studies, 4 cohort studies, and 14 case series studies. Comparing
FCSEMS with MPS, the pooled odds ratio was 0.48 [95% confidence
interval (CI): 0.22-1.05] (P=0.07) for stricture resolution, 0.3 (95% CI:
0.1-0.92) (P=0.03) for adverse event, 1.9 (95% CI: 0.3-12) (P=0.49) for
stent migration, and 1.38 (95% CI: 0.36-5.3) (P=0.34) for stricture
recurrence. The pooled rates for stricture recurrence of MPS, FCSEMSC, and FCSEMS-M were 19%, 19%, and 7%, respectively. The pooled
rates for stent migration were 4% of MPS, 25% of FCSEMS-C, and 3%
of FCSEMS-M.
Conclusions:
FCSEMS-M is more favorable in the management of
BBS comparing with MPS or FCSEMS-C. The biodegradable stent
may be a promising option but currently available data is insufficient to draw a firm conclusion.
Additional Metadata | |
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doi.org/10.1097/mcg.0000000000001193, hdl.handle.net/1765/117748 | |
Journal of Clinical Gastroenterology | |
Organisation | Erasmus MC: University Medical Center Rotterdam |
Yang, Q., Liu, JY, Ma, W.J., Wang, J.K., Li, F.Y., Bramer, W., … Pan, Q. (2019). Efficacy of Different Endoscopic Stents in the Management of Postoperative Biliary Strictures A Systematic Review and Meta-analysis. Journal of Clinical Gastroenterology, 53(6), 418–426. doi:10.1097/mcg.0000000000001193 |