TY  - JOUR
A1  - Kubesch, Alica
A1  - Görnert, Fabian
A1  - Filmann, Sonja Natalie
A1  - Bojunga, Jörg
A1  - Zeuzem, Stefan
A1  - Jung, Michael
A1  - Friedrich-Rust, Mireen
A1  - Walter, Dirk Henning
T1  - Impact of a shorter replacement interval of plastic stents on premature stent exchange rate in benign and malignant biliary strictures
T2  - Journal of gastroenterology and hepatology
N2  - Background and Aim: The main disadvantage of plastic stents is the high rate of stent occlusion. The usual replacement interval of biliary plastic stents is 3 months. This study aimed to investigate if a shorter interval of 6–8 weeks impacts the median premature exchange rate (mPER) in benign and malignant biliary strictures.
Methods: All cases with endoscopic retrograde cholangiopancreatography (ERCP) and plastic stent placement were retrospectively analyzed since establishing an elective replacement interval of every 6–8 weeks at our institution and mPER was determined.
Results: A total of 3979 ERCPs (1199 patients) were analyzed, including 1262 (31.7%) malignant and 2717 (68.3%) benign cases, respectively. The median stent patency (mSP) was 41 days (range 14–120) for scheduled stent exchanges, whereas it was 17 days (1–75) for prematurely exchanged stents. The mPER was significantly higher for malignant (28.1%, 35–50%) compared with benign strictures (15.2%, 10–28%), P < 0.0001, respectively. mSP was significantly shorter in cases with only one stent (34 days [1–87] vs 41 days [1–120]) and in cases with only a 7-Fr stent (28 days [2–79]) compared with a larger stent (34 days [1–87], P = 0.001). Correspondingly, mPER was significantly higher in cases with only one stent (23% vs 16.2%, P < 0.0001) and only a 7-Fr stent (31.3% vs 22.4%, P = 0.03).
Conclusion: A shorter replacement interval does not seem to lead to a clinically meaningful reduction of mPER in benign and malignant strictures. Large stents and multiple stenting should be favored as possible.
KW  - biliary stricture
KW  - double-pigtail stents
KW  - endoscopic retrograde cholangiography
KW  - stent patency
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/76318
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-763186
SN  - 1440-1746
N1  - Open access funding enabled and organized by Projekt DEAL.
VL  - 37
IS  - 6
SP  - 1076
EP  - 1082
PB  - Wiley-Blackwell
CY  - Oxford ; Malden, Mass
ER  -