Impact of biliary stent-related events in patients diagnosed with advanced pancreatobiliary tumours receiving palliative chemotherapy

Table 6 Summary of the available literature exploring the role of prophylactic treatment for stent-related event

Disease	Ref.	Randomised	Type of stent	Total number of patients	Number of patients per arm	Treatment arm(s): Stent insertion plus….	Investigation and result
Benign	Sciumè et al[21], 2004	Yes	Plastic	90	49/41	Ursodeoxycholic acid and levofloxacin vs Ursodeoxycholic acid alone	Longer stent patency with lower cholangitis and admission rate.
		(not blinded)
	Katsinelos et al[22], 2008	Yes	Plastic	41	21/20	Ursodeoxycholic acid vs Placebo	Common bile duct stones. No reduction in the bile duct stone size.
		(blinded)
	Han et al[23], 2009	No	Plastic	28	28	Ursodeoxycholic acid and terpene	Gallstones in elderly patients. Size of gallstones was reduced.
	Lee et al[24], 2011	No	Plastic	51	51	Ursodeoxycholic acid	Gallstones in elderly patients. No benefit of adding Ursodeoxycholic acid.
	Nishizawa et al[25], 2013	No	Plastic	36 patients, 63 procedures	Non-randomised, two arms: 20/43 procedures	Ursodeoxycholic acid vs Observation	Bile duct stones. Longer patency time and reduction in gallstone size in the intervention cohort.
Malignant	Ghosh et al[26], 19941	Yes	Plastic	70	31/39	Ursodeoxycholic acid + antibiotic (ampicillin, metronidazole, ciprofloxacin) vs Observation	No differences in stent occlusion rate.
		(not blinded)
	Barrioz et al[27], 19941	Yes	Plastic	20	Not specified	Ursodeoxycholic acid and norfloxacin vs Observation	Longer stent patency, prolonged median survival and shorter mean hospital stay.
		(not blinded)
	Luman et al[28], 19991	Yes	Not specified	40	20/20	Ciprofloxacin and rowachol vs Observation	Similar rate of obstruction and time to event.
		(not blinded)
	Sung et al[29], 19991	Yes	Plastic	58	Not specified	Ursodeoxycholic acid vs Observation	Similar rate of obstruction and time to event.
		(not blinded)
	De Lédinghen et al[30], 20001	Yes	Plastic	62	33/29	Ursodeoxycholic acid and norfloxacin vs Observation	Stopped after the interim analysis. No differences in stent patency.
		(not blinded)
	Halm et al[31], 20012	Yes	Plastic	52	26/26	Ursodeoxycholic acid and ofloxacin vs Ursodeoxycholic acid alone	Similar rate of obstruction and times to stent obstruction.
		(not blinded)
	Chan et al[32], 20052	Yes	Plastic	94	50/44	Ciprofloxacin vs Placebo	No differences in stent patency. Lower rate of cholangitis, but there was improvement in quality of life.
		(double blinded)

Overall, studies are underpowered for reaching definitive conclusions.

¹These studies were included in The Cochrane review[33];

²These studies were not included in The Cochrane review[33].