PubMed · 6036207
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
F L Iber. 1967. Cholestasis.. https://doi.org/10.1080/00325481.1967.11696099
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Explore the source record for details and available documents.
Expandable metal stents are a significant advance in the treatment of malignant gastrointestinal tract obstruction. The devices available are not perfect in design and need further technical improvement. However they already offer advantages over conventional plastic stents. They are becoming standard for esophageal stenting. Indications for metal stents in other locations of the gastrointestinal tract have to be evaluated. Endoscopic stenting is now the method of choice in the palliative treatment of jaundice in patients with inoperable biliopancreatic neoplasias. Stent clogging as a result of biliary sludge and biofilm remains an unsolved problem of plastic stents. Expandable metal stents remain patent longer but are reserved for patients with good general health.
PURPOSE: The intent of this systematic overview was to describe the clinical role of metal stents in nonvascular health care interventions and the level of evidence supporting their use. MATERIALS AND METHODS: Structured searches of Medline were conducted and limited to original peer-reviewed articles published in English. RESULTS: Clinical practice involving metal stents was reported in more than 109 clinical series involving 4,753 patients. Stents were placed mainly for palliation of malignant biliary, esophageal, and airway obstruction in patients who were untreatable or had surgically unresectable lesions. Assessment of these interventions has so far centered on safety and technical success. Efficacy, quality of life, and costing factors were not routinely reported. Randomized trial evidence was available but limited; six randomized trials involving metal stents have been reported. Three trials involved biliary malignant obstruction, and all three reported metal stent (132 patients) palliation to be superior to plastic stent palliation (136 patients) based on longer patency and lower reintervention costs. Safety and complication differences between stents, however, were inconsistent across trials. In three trials involving esophageal malignant obstruction, metal stent (82 patients) palliation was reported to be superior to plastic stent (41 patients), based on lower complication and reintervention rates, and superior to laser therapy (18 patients), based on better dysphagia relief. CONCLUSION: Use of metal stents has been reported for obstructed ducts and passageways of most body systems. There is, however, limited controlled trial evidence confirming the advantages of their use over plastic stents or other forms of treatment.