Efficacy and cost-effectiveness analysis of unilateral fully covered metal stents and bilateral plastic stents in endoscopic drainage for malignant hilar biliary obstruction
Ren Pengcheng
Lin Jing
Wu Puxian
Wang Hongxia
Wang Xiang
Abstract：Objective To investigate the efficacy and cost-effectiveness of unilateral fully covered metal stents and bilateral plastic stents in endoscopic drainage for malignant hilar bile duct obstruction(HMBO).Methods Patients who underwent endoscopic retrograde cholangiopancreatography and biliary stent placement due to unresectable HMBO(Bismuth type Ⅱ-Ⅳ)in the Second Hospital,Lanzhou University from May 2020 to May 2024 were retrospectively collected.A total of 76 patients were enrolled and divided into unilateral fully covered metal stent group(group A,31 cases)and bilateral plastic stent group(group B,45 cases).The primary outcome was clinical success rate,and the secondary outcome was stent patency time,hospital stay,and surgery-related costs.Results There was no significant difference in clinical success rate and length of hospital stay between the two groups(all P＞0.05).The stent patency time of group A was longer than that of group B[Bismuth type Ⅱ-Ⅲ:(180±118)d vs(92±70)d;Bismuth type Ⅳ:(210±122)d vs(85±61)d],and the surgery-related cost was higher than that of group B[Bismuth type Ⅱ-Ⅲ:(49±15)thousand yuan vs(29±10)thousand yuan;Bismuth Ⅳ type:(50±16)thousand yuan vs(25±8)thousand yuan](all P＜0.05).Conclusions Endoscopic stent drainage is an effective palliative treatment for HMBO.Unilateral fully covered metal stent drainage has certain advantages in stent patency time,and bilateral plastic stent drainage has certain advantages in hospitalization cost,but more large sample clinical studies are needed to further confirm.
Keywords：Malignant hilar biliary obstructionEndoscopic retrograde cholangiopancreatographyBiliary stentStent patency time
Publication Date：2025-11-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 1655-1658 )