Comparison of Uncovered and Covered Biliary SEMS for the Salvage of Obstructed SEMS: A Multicenter Retrospective Propensity Score–Weighted Study
4 affiliations
- 1Department of Internal Medicine Korea University Anam Hospital Seoul Republic of Korea
- 2Department of Gastroenterology, Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea
- 3Department of Internal Medicine, Ulsan University Hospital University of Ulsan College of Medicine Ulsan Republic of Korea
- 4Division of Gastroenterology, Department of Medicine, Faculty of Medicine Chulalongkorn University Bangkok Thailand
Abstract
Background and Aims: Recurrent biliary obstruction (RBO) is common after uncovered self‐expandable metal stent (UCSEMS) placement in unresectable distal malignant biliary obstruction. We compared stent patency, clinical outcomes, and RBO patterns between fully covered (FCSEMSs) and uncovered SEMSs (UCSEMSs) used as secondary stents after initial UCSEMS failure.
Methods: This multicenter retrospective study included 96 patients who underwent secondary SEMS placement for RBO (51 FCSEMSs, 45 UCSEMSs). Inverse probability of treatment weighting was applied. The primary outcome was stent patency; secondary outcomes included clinical success, adverse events (AEs), causes of RBO, and overall survival (OS).
Results: After adjustment, median stent patency was comparable between FCSEMSs and UCSEMSs (145 vs. 188 days; p = 0.435). Clinical success (92.2% vs. 98.2%; p = 0.146) and AE rates (12.2% vs. 6.0%; p = 0.323) were also similar. Tumor ingrowth was more common in the UCSEMS group, whereas sludge or food impaction was the predominant cause of RBO in the FCSEMS group.
Conclusions: FCSEMSs and UCSEMSs showed comparable clinical outcomes as secondary stents after initial UCSEMS failure. While overall outcomes were similar, RBO patterns differed by stent type, with tumor ingrowth more frequent in UCSEMSs and sludge impaction or tumor overgrowth in FCSEMSs.
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BibTeX
@article{lee2026comparison,
title = {{Comparison of Uncovered and Covered Biliary SEMS for the Salvage of Obstructed SEMS: A Multicenter Retrospective Propensity Score–Weighted Study}},
author = {Ho Seung Lee and Gunn Huh and Sung Hyun Cho and Dongwook Oh and Jae Min Lee and Tae Jun Song and Hoonsub So and Hong‐Sik Lee and Dong‐Wan Seo},
journal = {Journal of Gastroenterology and Hepatology},
year = {2026},
month = sep,
doi = {10.1111/jgh.70756},
url = {https://doi.org/10.1111/jgh.70756},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Comparison of Uncovered and Covered Biliary SEMS for the Salvage of Obstructed SEMS: A Multicenter Retrospective Propensity Score–Weighted Study
AU - Ho Seung Lee
AU - Gunn Huh
AU - Sung Hyun Cho
AU - Dongwook Oh
AU - Jae Min Lee
AU - Tae Jun Song
AU - Hoonsub So
AU - Hong‐Sik Lee
AU - Dong‐Wan Seo
PY - 2026
DA - 2026/09/22
JO - Journal of Gastroenterology and Hepatology
DO - 10.1111/jgh.70756
UR - https://doi.org/10.1111/jgh.70756
AB - Background and Aims: Recurrent biliary obstruction (RBO) is common after uncovered self‐expandable metal stent (UCSEMS) placement in unresectable distal malignant biliary obstruction. We compared stent patency, clinical outcomes, and RBO patterns between fully covered (FCSEMSs) and uncovered SEMSs (UCSEMSs) used as secondary stents after initial UCSEMS failure. Methods: This multicenter retrospective study included 96 patients who underwent secondary SEMS placement for RBO (51 FCSEMSs, 45 UCSEMSs). Inverse probability of treatment weighting was applied. The primary outcome was stent patency; secondary outcomes included clinical success, adverse events (AEs), causes of RBO, and overall survival (OS). Results: After adjustment, median stent patency was comparable between FCSEMSs and UCSEMSs (145 vs. 188 days; p = 0.435). Clinical success (92.2% vs. 98.2%; p = 0.146) and AE rates (12.2% vs. 6.0%; p = 0.323) were also similar. Tumor ingrowth was more common in the UCSEMS group, whereas sludge or food impaction was the predominant cause of RBO in the FCSEMS group. Conclusions: FCSEMSs and UCSEMSs showed comparable clinical outcomes as secondary stents after initial UCSEMS failure. While overall outcomes were similar, RBO patterns differed by stent type, with tumor ingrowth more frequent in UCSEMSs and sludge impaction or tumor overgrowth in FCSEMSs.
SN - 0815-9319
SN - 1440-1746
ER -