SynthesisDigestive diseases and sciences2012
Management of occluded metal stents in malignant biliary obstruction: similar outcomes with second metal stents compared to plastic stents.
Synthesis in Digestive diseases and sciences, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 49 citations in OpenAlex.
- Endobiliary Radiofrequency Ablation in Cholangiocarcinoma: Current Evidence and Future Perspectives.Journal of clinical medicine · 2026Review
- Results of Endoscopic Treatment of Recurrent Malignant Biliary Obstruction in Patients with Self-Expanding Metal Stents.Digestive diseases and sciences · 2025Article
- Review
- Endoscopic Reintervention for Recurrence of Malignant Biliary Obstruction: Developing the Best Strategy.Gut and liver · 2022Review
- Article
- Endoscopic bilio-duodenal bypass: outcomes of primary and revision efficacy of combined metallic stents in malignant duodenal and biliary obstructions.Digestive diseases and sciences · 2014Article
- Endoscopic management of malignant biliary obstructions.Annals of gastroenterologyReview
- Endoscopic ultrasound-guided antegrade stenting in an occluded biliary self-expandable metal stent.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology AssociationArticle
- Placement of Palliative Stent With Guidance of a Percutaneous Transhepatic Stent.Journal of investigative medicine high impact case reportsArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCovered or uncovered self expandable metallic stents (SEMS) placed in patients with malignant biliary obstruction can occlude in 19-40 %, but optimal management is unclear.
aimWe sought to summarize current evidence regarding management of occluded SEMS in patients with malignant biliary obstruction.
methodsTwo investigators independently searched Pubmed, Embase, and Web of Science using pre-defined search criteria, and reviewed bibliographies of included studies. Data were independently abstracted by two investigators, and analyzed using RevMan. We compared strategies of second SEMS versus plastic stents with respect to the following outcomes: rate of second stent re-occlusion, duration of second stent patency, and survival.
resultsTen retrospective studies met inclusion criteria for the systematic review. Management options described were placement of an uncovered SEMS (n = 125), covered SEMS (n = 106), plastic stent (n = 135), percutaneous biliary drain (n = 7), mechanical cleaning (n = 18), or microwave coagulation (n = 7). Relative risk of re-occlusion was not significantly different in patients with second SEMS compared to plastic stents (RR 1.24, 95 % CI 0.92, 1.67, I(2) = 0, p 0.16). Duration of second stent patency was not significantly different between patients who received second SEMS versus plastic stents (weighted mean difference 0.46, 95 % CI -0.30, 1.23, I(2) = 83 %). Survival was not significantly different among patients who received plastic stents versus SEMS (weighted mean difference -1.13, 95 % CI -2.33, 0.07, I(2) 86 %, p = 0.07).
conclusionsAmong patients with malignant biliary obstruction and occluded SEMS, available evidence suggests a strategy of placing a plastic stent may be as effective as second SEMS. Limitations of these findings were that all studies were retrospective and heterogeneity between studies was detected for two of the outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.