Drug eluting biliary stents to decrease stent failure rates: A review of the literature

Table 4 Trials evaluating systemic treatments to prevent internal failure

Ref.	Journal	Study design	Study results
Humans
Barrioz et al[48]	Lancet (1994)	Randomized prospective	Drugs were associated with longer stent patency and shorter hospital stay
		25 - conservative treatment
		21 - ursodeoxycholic acid and norfloxacin
Coene et al[49]	Scandinavian Journal of Gastroenterology (1994)	Randomized prospective	Bile clogging did not correlate with bile viscosity. Mucolytic agents or antibiotics only effective when bile is highly viscous
		60 patients received either
		co-trimoxazole or
		N-acetylcysteine
Smit et al[50]	Gastrointestinal Endoscopy (1989)	Randomized prospective	Both doxycycline and aspirin reduced the dry weight of sludge. Doxycycline improved patient survival
		30 patients received either
		placebo or
		doxycycline or
		aspirin
Halm	Endoscopy (2001)	Randomized prospective	No difference in patient survival or stent occlusion
		26 - ursodeoxycholic acid
		26 - ursodeoxycholic acid + ofloxacin
De Lédinghen et al[51]	Digestive Diseases and Sciences (2000)	Randomized prospective	No difference in stent patency and patient survival
		29 - conservative treatment
		33 - ursodeoxycholic acid and norfloxacin
In vitro
Tsang et al[52]	Journal of Laboratory and Clinical Medicine (1997)	In vitro	Ampicillin and sulbactam inhibited biofilm formation
		4 - porcine bile
		4 - porcine bile + ampicillin + sulbactam