Multicenter randomized trial of 10-french versus 11.5-french plastic stents for malignant biliary obstruction

Mihir S. Wagh, Mario De Bellis, Evan L. Fogel, James T. Frakes, John F. Johanson, Tahir Qaseem, Douglas A. Howell, Glen A. Lehman, Stuart Sherman

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background. There is little prospective data on whether bigger plastic stents are better for patients with malignant biliary obstruction with jaundice. Goals. Multicenter prospective study to compare technical success, clinical response, stent occlusion, and patient survival in patients with malignant biliary obstruction randomized to 10-French or 11.5-French plastic stent. Study. Patients with malignant biliary obstruction were randomized to 10-French or 11.5-French biliary stents. Patients were prospectively assessed for stent occlusion, stent-related interventions, hospital stay, and change in bilirubin. Main outcome measurements included technical success, clinical response, rates of stent occlusion, and survival. Results. 234 patients (47 hilar and 187 common bile duct strictures) were randomized. Outcomes were similar for the 10-French and 11.5-French groups (technical success 99.1% versus 97.4%, P = 0.37). Overall, median stent survival was 213 days, but there was no statistically significant difference in stent survival between 10-French and 11.5-French stents (149 versus 258 days, P = 0.16). Stent survival was significantly longer when placed for common bile duct versus hilar strictures (231 versus 115 days, P = 0.049). Conclusions. The theoretical advantage of improved bile flow for the 11.5-French stent does not translate into more prolonged patency, better clinical response, and longer patient survival than the 10-French stent.

Original languageEnglish
Article number891915
JournalDiagnostic and Therapeutic Endoscopy
Volume2013
DOIs
Publication statusPublished - 2013

Fingerprint

Plastics
Multicenter Studies
Stents
Survival
Common Bile Duct
Pathologic Constriction
Jaundice
Bilirubin
Bile
Length of Stay
Prospective Studies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Multicenter randomized trial of 10-french versus 11.5-french plastic stents for malignant biliary obstruction. / Wagh, Mihir S.; De Bellis, Mario; Fogel, Evan L.; Frakes, James T.; Johanson, John F.; Qaseem, Tahir; Howell, Douglas A.; Lehman, Glen A.; Sherman, Stuart.

In: Diagnostic and Therapeutic Endoscopy, Vol. 2013, 891915, 2013.

Research output: Contribution to journalArticle

Wagh, Mihir S. ; De Bellis, Mario ; Fogel, Evan L. ; Frakes, James T. ; Johanson, John F. ; Qaseem, Tahir ; Howell, Douglas A. ; Lehman, Glen A. ; Sherman, Stuart. / Multicenter randomized trial of 10-french versus 11.5-french plastic stents for malignant biliary obstruction. In: Diagnostic and Therapeutic Endoscopy. 2013 ; Vol. 2013.
@article{1495d4de43e04b80be0eab37aec6c262,
title = "Multicenter randomized trial of 10-french versus 11.5-french plastic stents for malignant biliary obstruction",
abstract = "Background. There is little prospective data on whether bigger plastic stents are better for patients with malignant biliary obstruction with jaundice. Goals. Multicenter prospective study to compare technical success, clinical response, stent occlusion, and patient survival in patients with malignant biliary obstruction randomized to 10-French or 11.5-French plastic stent. Study. Patients with malignant biliary obstruction were randomized to 10-French or 11.5-French biliary stents. Patients were prospectively assessed for stent occlusion, stent-related interventions, hospital stay, and change in bilirubin. Main outcome measurements included technical success, clinical response, rates of stent occlusion, and survival. Results. 234 patients (47 hilar and 187 common bile duct strictures) were randomized. Outcomes were similar for the 10-French and 11.5-French groups (technical success 99.1{\%} versus 97.4{\%}, P = 0.37). Overall, median stent survival was 213 days, but there was no statistically significant difference in stent survival between 10-French and 11.5-French stents (149 versus 258 days, P = 0.16). Stent survival was significantly longer when placed for common bile duct versus hilar strictures (231 versus 115 days, P = 0.049). Conclusions. The theoretical advantage of improved bile flow for the 11.5-French stent does not translate into more prolonged patency, better clinical response, and longer patient survival than the 10-French stent.",
author = "Wagh, {Mihir S.} and {De Bellis}, Mario and Fogel, {Evan L.} and Frakes, {James T.} and Johanson, {John F.} and Tahir Qaseem and Howell, {Douglas A.} and Lehman, {Glen A.} and Stuart Sherman",
year = "2013",
doi = "10.1155/2013/891915",
language = "English",
volume = "2013",
journal = "Diagnostic and Therapeutic Endoscopy",
issn = "1070-3608",
publisher = "Hindawi Publishing Corporation",

}

TY - JOUR

T1 - Multicenter randomized trial of 10-french versus 11.5-french plastic stents for malignant biliary obstruction

AU - Wagh, Mihir S.

AU - De Bellis, Mario

AU - Fogel, Evan L.

AU - Frakes, James T.

AU - Johanson, John F.

AU - Qaseem, Tahir

AU - Howell, Douglas A.

AU - Lehman, Glen A.

AU - Sherman, Stuart

PY - 2013

Y1 - 2013

N2 - Background. There is little prospective data on whether bigger plastic stents are better for patients with malignant biliary obstruction with jaundice. Goals. Multicenter prospective study to compare technical success, clinical response, stent occlusion, and patient survival in patients with malignant biliary obstruction randomized to 10-French or 11.5-French plastic stent. Study. Patients with malignant biliary obstruction were randomized to 10-French or 11.5-French biliary stents. Patients were prospectively assessed for stent occlusion, stent-related interventions, hospital stay, and change in bilirubin. Main outcome measurements included technical success, clinical response, rates of stent occlusion, and survival. Results. 234 patients (47 hilar and 187 common bile duct strictures) were randomized. Outcomes were similar for the 10-French and 11.5-French groups (technical success 99.1% versus 97.4%, P = 0.37). Overall, median stent survival was 213 days, but there was no statistically significant difference in stent survival between 10-French and 11.5-French stents (149 versus 258 days, P = 0.16). Stent survival was significantly longer when placed for common bile duct versus hilar strictures (231 versus 115 days, P = 0.049). Conclusions. The theoretical advantage of improved bile flow for the 11.5-French stent does not translate into more prolonged patency, better clinical response, and longer patient survival than the 10-French stent.

AB - Background. There is little prospective data on whether bigger plastic stents are better for patients with malignant biliary obstruction with jaundice. Goals. Multicenter prospective study to compare technical success, clinical response, stent occlusion, and patient survival in patients with malignant biliary obstruction randomized to 10-French or 11.5-French plastic stent. Study. Patients with malignant biliary obstruction were randomized to 10-French or 11.5-French biliary stents. Patients were prospectively assessed for stent occlusion, stent-related interventions, hospital stay, and change in bilirubin. Main outcome measurements included technical success, clinical response, rates of stent occlusion, and survival. Results. 234 patients (47 hilar and 187 common bile duct strictures) were randomized. Outcomes were similar for the 10-French and 11.5-French groups (technical success 99.1% versus 97.4%, P = 0.37). Overall, median stent survival was 213 days, but there was no statistically significant difference in stent survival between 10-French and 11.5-French stents (149 versus 258 days, P = 0.16). Stent survival was significantly longer when placed for common bile duct versus hilar strictures (231 versus 115 days, P = 0.049). Conclusions. The theoretical advantage of improved bile flow for the 11.5-French stent does not translate into more prolonged patency, better clinical response, and longer patient survival than the 10-French stent.

UR - http://www.scopus.com/inward/record.url?scp=84877968287&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877968287&partnerID=8YFLogxK

U2 - 10.1155/2013/891915

DO - 10.1155/2013/891915

M3 - Article

C2 - 23737656

AN - SCOPUS:84877968287

VL - 2013

JO - Diagnostic and Therapeutic Endoscopy

JF - Diagnostic and Therapeutic Endoscopy

SN - 1070-3608

M1 - 891915

ER -