In prospective trials in patients with malignant biliary obstruction, it has been reported that Wallstents prolong stent patency, but this does not translate into a significant survival benefit.
Compared with prospective trials, however, survival may be different in clinical practice because of differences in patient compliance.
We report on a retrospective, long term analysis comparing Wallstents versus plastic stents.
Plastic endoprostheses (70 patients) and endoscopic Wallstents (95 patients) were placed in 165 consecutive patients with irresectable, malignant biliary obstruction in a first (1990-91) and second (1992-93) time period.
Stent occlusion was treated by plastic stent placement.
Patient characteristics were quite comparable in both stent groups.
Initial placement of a Wallstent resulted in an increase of median stent patency of the first (10 vs 4 months, p<0.001) and second (8 vs 3 months, p<0.05) stent, a decrease of additional endoscopic procedures (20 vs 58%, p<0.005), an increase of patient compliance reflected by a decrease of patients dying with untreated stent occlusion (9 vs 30%, p<0.001), and an increase of survival time (6.5 vs 4 months, p<0.05).
Initial placement of a Wallstent results in an increase of stent patency of the first and second stent.
Duration of stent patency appears to have a determinant effect on patient compliance.
Increased stent patency and patient compliance seem to ...
Mots-clés Pascal : Tumeur maligne, Voie biliaire, Obstruction, Stent, Endoprothèse, Pronostic, Coût, Long terme, Survie, Homme, Suisse, Europe, Appareil digestif pathologie, Voie biliaire pathologie, Traitement instrumental, Traitement palliatif
Mots-clés Pascal anglais : Malignant tumor, Biliary tract, Obstruction, Stent, Endoprosthesis, Prognosis, Costs, Long term, Survival, Human, Switzerland, Europe, Digestive diseases, Biliary tract disease, Instrumentation therapy
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0234662
Code Inist : 002B26F. Création : 199608.