Are self-expandable metal stents superior to plastic stents in palliating malignant distal biliary strictures? A meta-analysis and systematic review
Journal Title: Medical Journal Armed Forces - Year 2017, Vol 73, Issue 1
Abstract
Background: Palliation for inoperable malignant distal biliary strictures can be achieved with self-expandable metal stents (SEMS) and plastic stents (PS). This is a meta-analysis to compare PS and SEMS. The aim of the study is to compare clinical outcomes in patients with SEMS and PS. Methods: Study selection criteria were studied using SEMS and PS for palliation in patients with malignant distal biliary stricture. For data collection and extraction, articles were searched in Ovid journals, Medline, Cochrane database, and Pubmed. Pooled proportions were calculated using both Mantel–Haenszel method and DerSimonian Laird method for statistical analysis. Results: Initial search identified 1376 reference articles, of which 112 were selected and11 studies (N = 947) were included in this analysis. Pooled analysis showed SEMS patency to be 167.7days (95% CI = 159.2–176.3) compared to 73.3days (95% CI = 69.8–76.9) in PS. SEMS have lower odds of occlusion when compared to PS with an odds ratio of 0.48 (95% CI = 0.34–0.67). SEMS has a lower odds of cholangitis compared to SP, with an odds ratio of 0.46 (95% CI = 0.30–0.69). Conclusion: SEMS seem to be superior to PS with better patency periods and survival duration. SEMS have lower occlusion rates, re-intervention rates, and cholangitis.
Authors and Affiliations
Harsha Moole
Keywords
Related Articles
- EP ID EP635004
- DOI 10.1016/j.mjafi.2016.08.014
- Views 62
- Downloads 0
Private sector involvement envisaged in the National Strategic Plan for Tuberculosis Elimination 2017-2025: Can Tuberculosis Health Action Learning Initiative model act as a road map?
Tuberculosis (TB), one of the oldest diseases known to mankind has become a notifiable disease. Public private mixes guidelines for TB programme managers had already been published by Central TB Division in the Ministry...
Seroprevalence of dengue infection in pregnant women and placental antibody transfer
Background: Pregnant women and infants are vulnerable for developing severe dengue. This study was conducted to determine the seroprevalence of dengue infections among pregnant women, their offsprings and its association...
Study of pain response in neonates during venipuncture with a view to analyse utility of topical anaesthetic agent for alleviating pain
Background: Neonates being nonverbal are unable to express their pain leading to underestimation of their pain and hence insufficient pain relief. Neonatal pain is assessed by pain scales based on the behavioural and phy...
Varicella bullosa in an adult
Varicella or chickenpox caused by varicella zoster virus is a very common viral infection occurring worldwide with a peak in late winters and early summers. Before the advent of varicella vaccine, about 90–95% of cases o...
A case of 'blue skin' and 'dark urine'
A 60-year-old female presented with a 20-year history of progressive dark bluish discoloration of skin and passage of dark colored urine, painful arthritis and a recent history of invasive ductal carcinoma of right breas...