Comparative analysis of endoscopic stenting fully covered with self-expandable stents in patients with unresectable distal biliary obstruction

The aim of the study was a comparative analysis of the longterm results of the functioning of covered selfexpandable metal stents (CSEMS) with a diameter of 8 and 10 mm with distal malignant biliary obstruction (DMBO). In the Botkin hospital (Moscow) for the period from 2010 to 2018 according to the criteria, the study included 74 patients with endoscopic stenting CSEMS with DMBO. Patients were divided into 2 groups: 1 - 33 CSEMS with a diameter of 8 mm, 2 - CSEMS with a diameter of 10 mm. The groups were statistically homogeneous. Clinical success was achieved in 94.3% of patients in group 1 and 95.8% of patients in group 2 (p = 0.096). Acute cholecystitis: 1 to 3 (9.6%); 2-5 (11.6%) (p = 0.139); acute pancreatitis:1 - 5 (16.1%); 2 - 9 (20.9%) (p = 0.067). Average time to repeated biliary obstruction: 1 - 244 days; 2 - 269 days (p = 0.119). The median (range) of theobservation period was: 1 - 174 (34-385) days; 2 - 193 (19-406) days (p = 0.836). Median survival: 1 - 156 days; 2 - 138 days (p = 0.716). The frequency of cases without repeated biliary obstruction at the time of death was: 1 - 58.1% (18/31); 2 - 65.1% (28/43) (p = 0.046). Thus, we can conclude that it is not possible to use CSEMS with a diameter of 8 or 10 mm with DMBO without significant influence on longterm results.