alexa Are Double-Layer Stents Better than Plastic Stents and Self-Expandable Metal Stents in Palliating Malignant Biliary Obstruction? Meta-Analysis and Systematic Review
ISSN: 2161-069X

Journal of Gastrointestinal & Digestive System
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Research Article

Are Double-Layer Stents Better than Plastic Stents and Self-Expandable Metal Stents in Palliating Malignant Biliary Obstruction? Meta-Analysis and Systematic Review

Harsha Moole1*, Matthew L. Bechtold2, Micheal Cashman3, Fritz H Volmar3, Sonu Dhillon3, David Forcione4 and Srinivas R Puli3

1Division of General Internal Medicine, University of Illinois College of Medicine at Peoria, Illinois, USA

2Division of Gastroenterology and Hepatology, University of Missouri, Columbia, Missouri, USA

3Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA

4Interventional Endoscopy Services, Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA

Corresponding Author:
Harsha Moole, MD
Department of Internal Medicine
University of Illinois College of Medicine Peoria
530 NE Glen Oak Ave, Peoria, Illinois, 61637, USA
Tel: +1 (309) 655-2730
Fax: 001 (309) 655-2755
E-mail: [email protected]

Received Date: June 18, 2016; Accepted Date: July 27, 2016; Published Date: August 03, 2016

Citation: Moole H, Bechtold ML, Cashman M, Volmar FH, Dhillon S, et al. (2016) Are Double-Layer Stents Better than Plastic Stents and Self-Expandable Metal Stents in Palliating Malignant Biliary Obstruction? Meta-Analysis and Systematic Review. J Gastrointest Dig Syst 6:459. doi:10.4172/2161-069X.1000459

Copyright: © 2016 Moole H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Double layer stents (DLS) were designed to overcome the limitations of plastic stents (PS) and self-expandable metal stents (SEMS) in palliating inoperable malignant biliary obstructions (MBO). Aims: Primary outcomes are stent patency period, occlusion rates and adverse events. Methods: Study Selection Criteria: Studies using DLS, SEMS and PS for palliation of patients with inoperable MBO. Data collection and extraction: Articles were searched in Pubmed and Ovid. Statistical method: Pooled proportions were calculated using both fixed and random effects model. Results: Initial search identified 374 reference articles, of which 41 were selected and reviewed. Five studies (N=460) for DLS, SEMS and PS which met the inclusion criteria were included in this analysis. Pooled analysis by fixed effects showed DLS patency to be 118.9 days (95% CI=110.4 to 127.4) compared to 77.4 days (95% CI=70.2 to 84.6) in PS and 170.7 days (95% CI=154.4 to 187.0) in SEMS. Stent occlusion rates in DLS, PS and SEMS group were 8.1% (95% CI=7.1 to 9.0), 37.5% (95% CI=33.8 to 41.1) and 19.9% (95% CI=18.1 to 21.7) respectively. Conclusions: In palliating inoperable MBO patients, DLS seem to be superior to PS. SEMS tend to have higher occlusion rates compared to DLS.

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