Biliary metal stents should be placed near the hilar duct in distal malignant biliary stricture patients

Table 2 Outcome of biliary self-expandable metallic stent placement

Variable	Hilar group (n = 83)	Lower group (n = 44)	P value
Year of procedure			0.18
2011-2015	48 (57.8)	31 (70.5)
2016-2021	35 (42.2)	13 (29.5)
Diameter of SEMS			1.0
8 mm	1 (1.2)	0 (0)
10 mm	82 (98.8)	44 (100)
USEMS:CSEMS	35:48	20:24	0.85
USEMS used
BileRush	2 (2.4)	1 (2.3)	1
Bonastent	1 (1.2)	0 (0)	1
HANARO	1 (1.2)	0 (0)	1
Niti-S Large cell	9 (10.8)	5 (11.4)	1
WallFlex	24 (28.9)	7 (15.9)	0.13
X Suit NIR	0 (0)	2 (4.5)	0.12
Zilver	0 (0)	1 (2.3)	0.35
Zilver 635	4 (4.8)	6 (13.6)	0.09
CSEMS used
Bonastent	0 (0)	1 (2.3)	0.35
HANARO	3 (3.6)	1 (2.3)	1
Niti-S Comvi	11 (13.3)	7 (15.9)	0.79
WallFlex	28 (33.7)	7 (15.9)	0.038
X Suit NIR	0 (0)	6 (13.6)	< 0.01
Technical success	83 (100)	44 (100)
Functional success	81 (97.6)	41 (93.2)	0.34
Adverse events	2 (2.4)	0 (0)	0.54
Pancreatitis	2	0
Mild	2	0
Post-EST bleeding	1	0
Severe	1	0
SEMS shortening1	1 (1.3)	2 (4.7)	0.28
SEMS dysfunction	2 (2.4)	18 (41)	< 0.01
Cause of SEMS dysfunction
Ingrowth	1	3
Overgrowth	1	2
Ingrowth and overgrowth		8
Top edge closed by CBD wall		4
Dislocation		1
Observational period, months	4.16 ± 5.76	9.12 ± 12.07	0.012

Values are presented as n, n (%), or mean ± SD.

¹The presence or absence of SEMS shortening was confirmed in 79 patients in the Hilar group and 43 patients in the Lower group.

SEMS: Self-expandable metallic stent; USEMS: Uncovered SEMS; CSEMS: Covered SEMS; EST: Endoscopic sphincterotomy; CBD: Common bile duct.