A comparison of metal and plastic stents for the relief of jaundice in unresectable malignant biliary obstruction in Korea: an emphasis on cost-effectiveness in a country with a low ERCP cost.
Gastrointest Endosc
; 70(2): 284-9, 2009 Aug.
Article
en En
| MEDLINE
| ID: mdl-19539921
ABSTRACT
BACKGROUND:
In countries where ERCP costs are low relative to those of metal stents (eg, Korea), initial endoscopic retrograde biliary drainage (ERBD) with a plastic stent is thought to be more economical.OBJECTIVE:
We conducted this study to compare metal and plastic stent-based ERBD in efficacy, complications, and total cost of biliary drainage.DESIGN:
Retrospective study.SETTING:
Tertiary referral center. PATIENTS A total of 112 patients who had not undergone previous biliary drainage procedures and who underwent ERBD for unresectable malignant biliary obstruction.INTERVENTIONS:
Endoscopic sphincterotomy was performed, and covered or uncovered Wallstents were used in 56 patients and plastic stents in 56 patients.RESULTS:
Stent occlusion occurred in 31 patients after a mean of 278 days in the metal stent group and in 39 patients after a mean of 133 days in the plastic stent group (P = .0004). The incidence of and length of hospitalization for cholangitis were significantly lower in the metal stent group. There was no difference in the total number of drainage procedures between the 2 groups. There was no statistical difference in the mean cost of the relief of jaundice between the 2 groups ($1488.77 in the metal stent group vs $1319.26 in the plastic stent group, P = .422).LIMITATIONS:
Nonrandomized, retrospective study.CONCLUSION:
Even in countries where ERCP costs are lower than those of metal stents, ERBD with metal biliary stents as the first-line treatment may offer better palliation without a significant increased cost in patients with unresectable malignant biliary obstruction.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_financiamento_saude
Asunto principal:
Stents
/
Colestasis
/
Colangiopancreatografia Retrógrada Endoscópica
/
Ictericia
Tipo de estudio:
Etiology_studies
/
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Gastrointest Endosc
Año:
2009
Tipo del documento:
Article
País de afiliación:
Corea del Sur