Background
Methods
Systematic search
Data extraction
Definitions
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Stenting time: the time between stent placement and removal. Stenting time in patients treated with uSEMS was defined as the time between stent placement and the moment that further treatment was indicated because of stent obstruction.
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Technical success: technically successful stent placement.
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Clinical success: no need for further treatment after stent placement, relief of symptoms and/or significant decrease in bilirubin level after stent placement.
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Complication: adverse event after stent placement, such as cholangitis, pancreatitis, stent migration or hemorrhage.
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Mortality: procedure-related and stent-related death.
Statistics
Results
Study types
Author | Year | N | Age (years (range)) | Women | Intervention | Route | Etiology stricture | Location obstruction |
---|---|---|---|---|---|---|---|---|
Prospective studies | ||||||||
Yamaguchi et al [63] | 2006 | 8 | median 65,7 (42-78) | 0 | Streckerstent (2) | ERCP | chronic pancreatitis | CBD |
O Brien et al [58] | 1998 | 8 | median 59 (26-88) | unknown | Wallstent | ERCP | postoperative/endoscopic (5) | hilair (3) |
chronic pancreatitis (2) | proximal (5) | |||||||
idiopathic (1) | ||||||||
Deviere et al [15] | 1994 | 20 | mean 45 (27-61) | 4 | Wallstent | ERCP | chronic pancreatitis | CBD |
Mygind et al (75) | 1993 | 2 | unknown | 2 | Z stent | PTC | post operative | CBD (1) |
CBD and anastomosis (1) | ||||||||
Maccioni et al [56] | 1992 | 18 | mean 60 (22-76) | 8 | Z stent (17) | PTC | post operative | anastomosis (13) |
Wallstent (1) | CBD (5) | |||||||
Foerster et al [52] | 1991 | 7 | median 60 (49-80) | 5 | Wallstent | ERCP (6) | postoperative | anastomosis (2) |
PTC (1) | CBD (5) | |||||||
hepatoduodenal fistel (1) | ||||||||
Retrospective studies
| ||||||||
van Berkel et al [62] | 2004 | 13 | mean 56 (40-79) | 4 | Wallstent | ERCP | chronic pancreatitis | CBD |
Roumilhac et al [60] | 2003 | 12 | unknown | unknown | Metal stent (12) | ERCP | post OLT | anastomosis (11) |
Eickhoff et al [51] | 2003 | 6 | median 38 (29-60) | 1 | Wallstent | ERCP | chronic pancreatitis | CBD |
Kahl et al [55] | 2002 | 3 | mean 48 (21-81) | 1 | Wallstent (3) | ERCP | chronic pancreatitis | CBD |
Bonnel et al [49] | 1997 | 25 | mean 64 (35-86) | 13 | Z stent | PTC | postoperative | CBD (8) |
anastomosis (17) | ||||||||
Rieber et al [59] | 1996 | 8 | mean 42 (17-66) | 3 | Palmaz stent | PTC | post OLT | anastomosis (5) |
nonanastomotis (3) | ||||||||
Hausegger et al [53] | 1996 | 20 | mean 62 (36-83) | 7 | Wallstent | PTC | chronic pancreatitis (7) | anastomosis (4) |
fibrous papillary stenosis (2) | CBD (16) | |||||||
psc (1) | ||||||||
post operative (10) | ||||||||
Chu et al [50] | 1994 | 2 | unknown | unknown | Z stent | PTC | post operative | hilair (1) |
CBD (1) | ||||||||
Ivancev et al [54] | 1992 | 2 | 66 and 41 | 2 | Z stent | PTC | post operative | anastomosis (1) |
CBD (1) | ||||||||
Rossi et al [16] | 1990 | 17 | mean 60 (22-76) | 7 | Z stent | PTC | postoperative | anastomosis (13) |
CBD (4) |
Author | Year | N | Age (years (range)) | Women | Intervention | Route | Etiology stricture | Location obstruction |
---|---|---|---|---|---|---|---|---|
Prospective studies | ||||||||
Holt et al [32] | 2007 | 53 | 48,5 (37-61) | 32 | single plastic stent | ERCP | post OLT | anastomosis |
Graziadei et al [30] | 2006 | 84 | 53,5 | 21 | single plastic stent | ERCP | post OLT | anastomosis (65) |
non anastomosis (19) | ||||||||
Pozsar et al [48] | 2005 | 20 | mean 61,3 (36-81) | 18 | multiple plastic stents | ERCP | post sphincterectomy | distal CBD |
Kuzela et al [45] | 2005 | 43 | mean 50,3 (37-82) | 25 | multiple plastic stents | ERCP | post operative | hilair |
Kahl et al [34] | 2003 | 61 | median 47 (21-81) | 15 | single plastic stent | ERCP | chronic pancreatitis (61) | CBD |
Tocchi et al [38] | 2000 | 20 | mean 57 | 10 | single plastic stent | ERCP | post operative | CBD (3) |
hilair (17) | ||||||||
van Milligen et al [40] | 1997 | 16 | median 43 (17-69) | 8 | single plastic stent | ERCP | psc | CBD (10) |
hiliar (6) | ||||||||
Retrospective studies
| ||||||||
Pasha et al [47] | 2007 | 25 | mean 46,7 (28-59) | 4 | multiple plastic stents | ERCP | post OLT | anastomosis |
Elmi et al [28] | 2007 | 15 | 52 year (42-68) | 9 | single plastic stent | ERCP | post OLT | anastomosis |
Akay et al [21] | 2006 | 11 | 42 (17-60) | 6 | single plastic stent | ERCP | post OLT | anastomosis |
Sharma et al [37] | 2006 | 8 | median 42 (20-61) | 3 | single plastic stent | ERCP | idiopathic | CBD (6) |
hilair (2) | ||||||||
Alazmi et al [22] | 2006 | 143 | unknown | unknown | single plastic stent | ERCP | post OLT | anastomosis |
Zoepf et al [42] | 2005 | 7 | median 55 (45-65) | unknown | single plastic stent | ERCP | post OLT | anastomosis |
Cahen et al [25] | 2005 | 58 | median 54 (19-85) | 10 | single plastic stent | ERCP | chronic pancreatitis | CBD |
Catalano et al [64] | 2004 | 46 | mean 48 (30-71) | 11 | 1 plastic stent (34) | ERCP | chronic pancreatitis | CBD |
multiple plastic stents (12) | ||||||||
Morelli et al [46] | 2003 | 25 | mean 48 (18-72) | 9 | multiple plastic stents | post OLT | anastomosis | |
Hisatsune et al [31] | 2003 | 19 | 45 (14-67) | 9 | single plastic stent | ERCP | post OLT | anastomosis |
Eickhoff et al [27] | 2001 | 39 | mean 54,7 (32-81) | 7 | single plastic stent | ERCP | chronic pancreatitis (39) | CBD |
Bourke et al [43] | 2000 | 6 | mean 53 (20-64) | 3 | multiple plastic stents | ERCP | post sphyncterectomy | ampullary |
Khandekar et al [44] | 2000 | 17 | median 50 (17-68) | 13 | multiple plastic stents | ERCP | post sphyncterectomy (10) | CBD (14) |
papillotomy (2) | other (3) | |||||||
post operative (3) | ||||||||
Vitale et al [41] | 2000 | 25 | mean 46,7 (36-89) | 7 | single plastic stent | ERCP | chronic pancreatitis | CBD |
Kiehne et al [35] | 2000 | 14 | (36-89) | 2 | single plastic stent | chronic pancreatitis | CBD | |
Farnbacher et al [29] | 2000 | 31 | 50 (24-71) | 3 | single plastic stent | ERCP | chronic pancreatitis | CBD |
Rossi et al [36] | 1998 | 15 | mean 44 (28-55) | 6 | single plastic stent | ERCP | post OLT (15) | anastomosis |
De Masi et al [26] | 1998 | 53 | unknown | unknown | single plastic stent | ERCP | iatrogenic (39) | CBD (20) |
gallstones (8) | hilair (30) | |||||||
Aru et al [23] | 1997 | 8 | mean 44 | 7 | single plastic stent | ERCP | post operative | CBD (7) |
hilair (1) | ||||||||
van Milligen et al [39] | 1996 | 25 | median 42 (21-74) | 13 | single plastic stent | ERCP | psc | CBD (19) |
hilair (3) | ||||||||
Itani et al [33] | 1995 | 5 | unknown | unknown | single plastic stent | ERCP | chronic pancreatitis | CBD |
Barthet et al [24] | 1994 | 19 | mean 49 | 1 | single plastic stent | ERCP | chronic pancreatitis | CBD |
Deviere et al [2] | 1990 | 25 | mean 42 (34-69) | 1 | single plastic stent | ERCP | chronic pancreatitis | CBD |
Patients
Author | Intervention | Follow up (range) | Previous treatment | Technical success | Clinical succes | Treatment time Stentpatency | Total complications |
---|---|---|---|---|---|---|---|
Prospective studies | |||||||
Yamaguchi et al [63] | Streckerstent (2) | > 5 years (7.4 year) | plastic stent placement | 100% | 62,50% | unknown | 25% |
Wallstent (6) | |||||||
O Brien et al [58] | Wallstent | mean 64,5 months (26-81) | plastic stent placement (5) | 100% | unknown | median 35 months (7-57) | 75 |
Tesdal et al [69] | Wallstent (11) | mean 63,8 months | balloon dilatation (19) | 100% | unknown | mean 30,2 months | 64,50% |
Palmazstent (9) | median 80,5 (2-116) | ||||||
Streckerstent(4) | |||||||
Deviere et al [15] | Wallstent | mean 33 months (24-42) | plastic stent placement (11) | 100% | 90% | 3 and 6 months (2/20) | 10 |
Mygind et al (75) | Z stent | 4 and 7 months | balloon dilatation | 100% | 100% | unknown | unknown |
Maccioni et al [56] | Z stent (17) | mean 37 months (30-41) | percutaneous dilatation | 83,30% | 55,50% | unknown | 38,80% |
Wallstent (1) | |||||||
Foerster et al [52] | Wallstent | mean 32,7 weeks (21-53) | laparotomy (2) | 100% | 100% | 8 months until now | 14% |
Retrospective studies
| |||||||
van Berkel et al [62] | Wall stent | mean 50 months (6 d -86 months) | none | 100% | 69% | 60 months | 15,40% |
Roumhilac et al [60] | SEMS (12) | median 37 months (18-53) | plastic stent treatment for 1 year | 100% | 100% | no stent obstruction | unknown |
Eickhoff et al [51] | Wallstent | median 58 months (22-29) | plastic stent placement | 100% | unknown | median 20 months (10-38) | 83,40% |
Kahl et al [55] | Wallstent (3) | median 37 months (18-53) | plastic stent treatment for 1 year | 100% | 100% | no stent obstruction | unknown |
Bonnel et al [49] | Z stent | mean 55 months (9-84) | surgery (17) | 18 one approach | 72% | 36% | |
T tube (8) | 7 two approaches | ||||||
Rieber et al [59] | Palmaz stent | mean 18 months (1,5-43) | balloon dilatation | 100% | 62% occlusion | ||
post PTBD | occlussion time 1,5-2,5-24 months | ||||||
Hausegger et al [53] | Walsltent | mean 31,2 months (3-78) | balloon dilatation | 100% | unknown | 73% (6 months) | 50,00% |
38% (36 months) | |||||||
19% (end follow up) | |||||||
3-3-3-4-5-11-24-2-36-55 | |||||||
Chu et al [50] | Z stent | unknown | plastic stents | unknown | 0% | ||
PTBD | |||||||
Ivancev et al [54] | Z stent (2) | 9 and 14 months | balloon dilatation | 100% | 50% | 50% (5 months) | 50% |
Rossi et al [16] | Z stent | mean 8 months (4-12) | baloon dilatition | 100% | 82,40% | unknown | 11,80% |
Author | Intervention | Follow up (range) | Previous treatment | Technical success | Clinical succes | Treatment time Stentpatency | Total complications |
---|---|---|---|---|---|---|---|
Prospective studies | |||||||
Holt et al [32] | single plastic stent | 18 months | balloon dilatation | 92% | 69% | 11,3 months (7-14) | 69,70% |
Graziadei et al [30] | single plastic stent | mean 39,8 (0,3-98) | balloon dilatation | unknown | 77% anastomosis | unknown | 5-424 procedures |
0% non anastomosis | |||||||
Pozsar et al [48] | multiple stent placement | mean 61,3 (36-81) | dilatation | unknown | 90% | median 9 months (3-22) | 37,70% |
Kuzela et al [45] | multiple stent placement | median 16 months (1-42) | none | 100% | 100% | 1 year | 12% |
after stent placement | (planned) | ||||||
Tocchi et al [38] | single plastic stent | mean 89,7 months | none | 100% | 80% | unknown | 0% |
Kahl et al [34] | single plastic stent | median 40 months (18-66) | none | 100% | 31,1% (1 year) | 1 year (19) | 34,40% |
26,2% (40 months) | rest unknown | ||||||
van Milligen et al [40] | single plastic stent | median 19 months (7-27) | none | 100% | 81% | median 9 days | 7% |
Retrospective studies
| |||||||
Pasha et al [47] | multiple plastic stent | median 21,5 months (5,4-31,2) | diliatation | unknown | 88% (intend to treat) | median 4,6 months (1,1-11,9) | 27% |
Elmi et al [28] | single plastic stent | 535 days (22-1301) | balloondilatation | Unknown | 87% | 192 days (18-944) | 22,2% (procedure) |
sphincterectomy | |||||||
Akay et al [21] | single plastic stent | 22 months (SD 13 months) | balloondilatation | 75% | 55% | 3 months (6) | 12% |
6 months (1) | |||||||
9 months (1) | |||||||
12 months (3) | |||||||
Sharma et al [37] | single plastic stent | median 19 months (4-52) | balloondilatation | 100% | 100% | median 19 months | 18% |
Alazmi et al [22] | single plastic stent | mean 28 months (1-114) | balloondilatation | 6,60% | 82% | unknown | unknown |
Zoepf et al [42] | single plastic stent | median 9,5 months (1-36) | sometimes dilatation | 100% | 85,60% | median 8 months (2-26) | 18,60% |
Cahen et al [25] | single plastic stent | median 45 months (0-182) | sphincterectomy | 100% | 38% | median 274 days (3-2706) | 52% |
pancreatic duct stenting | |||||||
Catalano et al [64] | single plastic stent (34) | mean 4,2 years (1 plastic stent) | unknown | 100% | 24% 1 stent | 21 months | 42,7% (single plastic stent) |
multiple plastic stent (12) | mean 3,9 years (mulitple stents) | 92% multiple stents | 14 months | 8,3% (multiple plastic stent) | |||
Morelli et al [46] | multiple plastic stent | mean 54 weeks (5 wks - 103 mo) | diliatation | 88% | 90% | unknown | 3,70% |
Hisatsune et al [34] | single plastic stent | mean 26 months(15-44) | none | 79% | 93% | mean 637 days (487-933) | 43% |
Eickhoff et al [31] | single plastic stent | median 58 months (2-146) | balloon dilatation | 100% | 31% | mean 9 months (1-144) | 43% |
nasobiliary drainage | |||||||
Bourke et al [43] | multiple plastic stent | median 26,5 months (24-32) | dilatation | unknown | 100% | median 12,5 months | 33% |
Author
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Intervention
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Follow up (range)
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Previous treatment
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Technical success
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Clinical succes
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Treatment time
Stentpatency
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Total complications
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Khandekar et al [44] | multiple plastic stent | median 720 days | sometimes dilatation | Unknown | 100% | median 140 days (30-1080) | unknown |
Vitale et al [41] | single plastic stent | 32 months (13-76) | balloon dilatation | Unknown | 80% | mean 13,3 months | unknown |
Khiene et al [35] | single plastic stent | 1-5 years | none | 100% | 7,40% | unknown | 85,70% |
Farnbacher et al [29] | single plastic stent | 24 months (2-76) | none | 100% | 13% | 24 months (2-76 months) | 72% |
Rossi et al [36] | single plastic stent | 1 year | dilatation | 100% | 83,30% | 1 year | 33,30% |
De Masi et al [26] | single plastic stent | 6-84 months | unknown | Unknown | 71,40% | 24 months | 52,70% |
Aru et al [23] | single plastic stent | unknown | unknown | 100% | 25% | unknown | unknown |
van Millegen et al [39] | single plastic stent | mean 29 months (2-120) | dilatation nasobiliary drain | 84% | 76% | 1 stent period (17) | 30,5%(procedure) |
2 stent period (2) | |||||||
3 stent period (3) | |||||||
Itani et al [33] | single plastic stent | mean 7 months | dilatation | 100% | 80% | 4 months (2) | unknown |
1 change 4 months (2) | |||||||
15 months (1) | |||||||
Barthet et al [24] | single plastic stent | mean 18 months (13-48) | none | 100% | 42% | mean 10 months | 10,50% |
Deviere et al [2] | single plastic stent | mean 14 months (4-72) | dilatation | 100% | 12% | unknown | 72% |
Comparison between different stent types
Single plastic stent | USEMS | Multiple plastic stents | ||||
---|---|---|---|---|---|---|
Technical success | Clinical success | Technical success | Clinical success | Technical success | Clinical success | |
(mean) | (mean) | (mean) | (mean) | (mean) | (mean) | |
All indications | 94,10% | 61.3% | 98,50% | 62,40% | 97,60% | 87,50% |
Post operative | 86,6,% | 64,90% | 97,60% | 59,60% | 100 | 87,60% |
Chronic pancreatitis | 100% | 36,60% | 100% | 80,40% | NA | NA |
Post OLT | 97,20% | 81% | 100% | 50% | 88% | 89% |