Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2021; 27(28): 4697-4709
Published online Jul 28, 2021. doi: 10.3748/wjg.v27.i28.4697
New anti-reflux plastic stent to reduce the risk of stent-related cholangitis in the treatment of biliary strictures
Xiang-Lei Yuan, Lian-Song Ye, Xian-Hui Zeng, Qing-Hua Tan, Yi Mou, Wei Liu, Chun-Cheng Wu, Hang Yang, Bing Hu
Xiang-Lei Yuan, Lian-Song Ye, Xian-Hui Zeng, Qing-Hua Tan, Yi Mou, Wei Liu, Chun-Cheng Wu, Hang Yang, Bing Hu, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Hu B, Yuan XL, and Ye LS designed this study; Yuan XL, Ye LS, and Zeng XH analyzed and interpreted the data; Yuan XL, Ye LS, and Zeng XH drafted the manuscript; Hu B, Tan QH, Mou Y, Liu W, Wu CC, and Yang H critically revised the manuscript.
Institutional review board statement: The study protocol was approved by the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University.
Informed consent statement: Informed consent was waived by the Ethics Committee because of the retrospective nature of this study and anonymous data.
Conflict-of-interest statement: Prof. Bing Hu is one of the inventors of the antireflux plastic stent. He has worked in collaboration with Micro-Tech (Nanjing) Co. Ltd., Nanjing, China, to develop the stent. No free device was offered for this study. Authors disclosed no conflicts of interests.
Data sharing statement: No additional unpublished data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Bing Hu, MD, Professor, Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China.
Received: May 7, 2021
Peer-review started: May 7, 2021
First decision: June 6, 2021
Revised: June 8, 2021
Accepted: July 7, 2021
Article in press: July 7, 2021
Published online: July 28, 2021
Research background

Endoscopic biliary stenting is an established procedure for patients with biliary strictures. However, complications such as stent occlusion and stent-related cholangitis after stent placement may worsen the quality of patients’ life. Since duodenobiliary reflux is a major cause of those complications, the design of stents with an anti-reflux valve is a potential solution for reducing duodenobiliary reflux.

Research motivation

The authors have previously developed a new anti-reflux plastic stents (ARPSs) and conducted a clinical trial to compare the patency of ARPSs with that of traditional plastic stents (TPSs), which showed this new ARPS had a significantly longer stent patency. However, the role of this new ARPS in reducing the onset of stent-related cholangitis compared with TPS remains unknown.

Research objectives

In this study, the authors compared this new ARPS with TPS in patients with biliary strictures.

Research methods

The authors retrospectively reviewed the data of consecutive patients with biliary strictures who underwent first endoscopic biliary stenting between February 2016 and May 2019 at West China Hospital, Sichuan University from our prospectively collected database. According to the inclusion and exclusion criteria, eligible patients were included for analysis. The onset of stent-related cholangitis, stent patency, clinical success, and other adverse events were evaluated.

Research results

During the study period, 67 patients in the ARPS group and 66 patients in the TPS group were included. There was a significant difference when comparing the onset of stent-related cholangitis, which was significantly lower in the ARPS group than in the TPS group. The cumulative median stent patency in the ARPS group was significantly longer than that in the TPS group. No significant differences were noted in the rates of clinical success and other adverse events between both groups.

Research conclusions

This new ARPS results in superior to TPS in reducing the risk of stent-related cholangitis and prolonging stent patency.

Research perspectives

Multicenter studies with large samples are expected to evaluate further the safety and efficacy of this new ARPS.