European radiology · 2026
Outcomes of percutaneous metallic stenting for malignant bilioenterostomy stricture: a retrospective single-center study of 368 patients.
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Oh Chang Hoon, Gwon Dong Il, Yoon Hyun-Ki, Ko Gi-Young, Kim Jin Hyoung, Chu Hee Ho
Аннотация
OBJECTIVE: To evaluate the technical and clinical outcomes of percutaneous metallic stenting in patients with malignant bilioenterostomy obstruction and to identify risk factors affecting stent patency.
MATERIALS AND METHODS: This retrospective study included 368 patients (240 men, 128 women; mean age, 68.2 years; range, 39-95 years) who underwent percutaneous biliary metallic stent placement between March 2012 and November 2023. Patients were categorized into three groups based on stent type: covered, single uncovered, and double uncovered.
RESULTS: Technical success was achieved in all patients. Uncovered stents-single uncovered (n = 208; 56.5%) and double uncovered (n = 50; 13.6%)-were placed in 70.1% of patients, while covered stents were used in 29.9%. Major and minor complication rates were 1.1% and 1.9%. Successful internal drainage, defined as removal of the temporary drainage catheter, was achieved in 87.8% of patients. Median survival and stent patency times were 241 days (95% CI, 216-266) and 255 days (95% CI, 194.7-315.3). No significant factors were associated with overall survival. Stent occlusion occurred in 50.5% of patients, most commonly due to tumor ingrowth (74.3%). On multivariate Cox regression, double uncovered stent placement (HR, 0.440; 95% CI, 0.295-0.656; p < 0.001), covered stent placement (HR, 0.301; 95% CI, 0.161-0.564; p < 0.001), and post-stenting serum bilirubin < 2.0 mg/dL (HR, 0.715; 95% CI, 0.517-0.990; p = 0.043) were independent predictors of prolonged stent patency.
CONCLUSION: Percutaneous metallic stenting is a safe and effective treatment for malignant bilioenterostomy obstruction. Covered and double-uncovered stents are associated with longer stent patency.
KEY POINTS: Question: What are the technical and clinical outcomes of percutaneous metallic stenting in malignant bilioenterostomy obstruction, and which factors affect stent patency?
FINDINGS: Covered and double-uncovered stents showed significantly longer patency. Stent type and bilirubin < 2.0 mg/dL were independent predictors of patency.
CLINICAL RELEVANCE: Percutaneous metallic stenting is safe and effective for malignant bilioenterostomy obstruction. Covered and double uncovered stents prolong patency, supporting their use as preferred options to improve long-term biliary drainage and patient outcomes.
MATERIALS AND METHODS: This retrospective study included 368 patients (240 men, 128 women; mean age, 68.2 years; range, 39-95 years) who underwent percutaneous biliary metallic stent placement between March 2012 and November 2023. Patients were categorized into three groups based on stent type: covered, single uncovered, and double uncovered.
RESULTS: Technical success was achieved in all patients. Uncovered stents-single uncovered (n = 208; 56.5%) and double uncovered (n = 50; 13.6%)-were placed in 70.1% of patients, while covered stents were used in 29.9%. Major and minor complication rates were 1.1% and 1.9%. Successful internal drainage, defined as removal of the temporary drainage catheter, was achieved in 87.8% of patients. Median survival and stent patency times were 241 days (95% CI, 216-266) and 255 days (95% CI, 194.7-315.3). No significant factors were associated with overall survival. Stent occlusion occurred in 50.5% of patients, most commonly due to tumor ingrowth (74.3%). On multivariate Cox regression, double uncovered stent placement (HR, 0.440; 95% CI, 0.295-0.656; p < 0.001), covered stent placement (HR, 0.301; 95% CI, 0.161-0.564; p < 0.001), and post-stenting serum bilirubin < 2.0 mg/dL (HR, 0.715; 95% CI, 0.517-0.990; p = 0.043) were independent predictors of prolonged stent patency.
CONCLUSION: Percutaneous metallic stenting is a safe and effective treatment for malignant bilioenterostomy obstruction. Covered and double-uncovered stents are associated with longer stent patency.
KEY POINTS: Question: What are the technical and clinical outcomes of percutaneous metallic stenting in malignant bilioenterostomy obstruction, and which factors affect stent patency?
FINDINGS: Covered and double-uncovered stents showed significantly longer patency. Stent type and bilirubin < 2.0 mg/dL were independent predictors of patency.
CLINICAL RELEVANCE: Percutaneous metallic stenting is safe and effective for malignant bilioenterostomy obstruction. Covered and double uncovered stents prolong patency, supporting their use as preferred options to improve long-term biliary drainage and patient outcomes.