Cost analysis of a long-term randomized controlled study in biliary duct-to-duct anastomotic stricture after liver transplantation - PubMed (original) (raw)
Randomized Controlled Trial
. 2021 May;34(5):825-834.
doi: 10.1111/tri.13867. Epub 2021 Apr 1.
Giulio Santi 1, Roberto Rosa 1, Ilaria Parzanese 1, Federico Macchini 1, Andrea Tenca 1 2, Ilaria Fanetti 1, Federica Invernizzi 3, Maria Francesca Donato 3, Pietro Lampertico 3 4, Paolo Reggiani 5, Giorgio Rossi 4 5, Maurizio Vecchi 1 4, Roberto Penagini 1 4
Affiliations
- PMID: 33730421
- DOI: 10.1111/tri.13867
Free article
Randomized Controlled Trial
Cost analysis of a long-term randomized controlled study in biliary duct-to-duct anastomotic stricture after liver transplantation
Paolo Cantù et al. Transpl Int. 2021 May.
Free article
Abstract
Multiple plastic stent (MPS) for biliary anastomotic stricture (AS) after liver transplantation requires multiple procedures with consequent costs. To compare the success, adverse events and treatment-related costs of fully covered self-expandable metal stents (FCSEMS) versus MPS. Thirty liver transplant (LT) patients with clinically relevant naïve AS were prospectively randomized to FCSEMS or MPS, with stent numbers increased at 3-month intervals. Treatment costs per patient were calculated for endoscopic retrograde cholangiopancreatography (including all devices and stents) and overall hospital stay. Radiological success was achieved in 73% of FCSEMS (median indwelling period of 6 mos) and 93% of MPS patients (P = NS) (median period of 11 mos). AS recurrence occurred in 36% of FCSEMS and 7% of MPS patients (P = NS), and AS re-treatment was needed in 53% and 13% (P < 0.01), respectively, during follow-up of 60 (34-80) months. Stents migrated after 29% and 2.6% of FCSEMS and MPS procedures, respectively (P < 0.01). Including re-treatments, long-term clinical success was achieved in 28/30 (93%) patients. Overall treatment-related costs were similar between groups. In the subgroup of LT patients in clinical remission after first-line treatment, treatment costs were 41% lower per FCSEMS patient compared with MPS patients. FCSEMS did not perform better than MPS. FCSEMS migration increased the rate of re-treatment and costs.
Keywords: biliary anastomotic stricture; endoscopic retrograde cholangiopancreatography procedure; liver transplantation.
© 2021 Steunstichting ESOT. Published by John Wiley & Sons Ltd.
Similar articles
- Intraductal fully covered self-expandable metal stent versus multiple plastic stents for treating biliary anastomotic strictures after liver transplantation.
Sissingh NJ, de Vries BA, Inderson A, van Hoek B, van der Heide F, van Hooft JE. Sissingh NJ, et al. Gastrointest Endosc. 2023 Apr;97(4):704-712.e2. doi: 10.1016/j.gie.2022.11.018. Epub 2022 Nov 30. Gastrointest Endosc. 2023. PMID: 36460088 - Self-Expandable Metallic Stent Is More Cost Efficient Than Plastic Stent in Treating Anastomotic Biliary Stricture.
Jang S, Stevens T, Lopez R, Chahal P, Bhatt A, Sanaka M, Vargo JJ. Jang S, et al. Dig Dis Sci. 2020 Feb;65(2):600-608. doi: 10.1007/s10620-019-05665-9. Epub 2019 May 18. Dig Dis Sci. 2020. PMID: 31104197 - Long-term outcomes of fully covered self-expandable metal stents for refractory biliary strictures after living donor liver transplantation: a retrospective study at a tertiary center.
Cho SH, Lee HS, Huh G, Oh D, Song TJ, Seo DW, Lee SK. Cho SH, et al. Surg Endosc. 2024 Jun;38(6):3223-3230. doi: 10.1007/s00464-024-10837-4. Epub 2024 Apr 22. Surg Endosc. 2024. PMID: 38649493 - A practical approach to the endoscopic management of biliary strictures after liver transplantation.
Bofill A, Cárdenas A. Bofill A, et al. Ann Hepatol. 2024 Mar-Apr;29(2):101186. doi: 10.1016/j.aohep.2023.101186. Epub 2023 Nov 28. Ann Hepatol. 2024. PMID: 38035999 Review. - Endoscopic treatment of anastomotic biliary stricture after adult deceased donor liver transplantation with multiple plastic stents versus self-expandable metal stents: a systematic review and meta-analysis.
Landi F, de'Angelis N, Sepulveda A, Martínez-Pérez A, Sobhani I, Laurent A, Soubrane O. Landi F, et al. Transpl Int. 2018 Feb;31(2):131-151. doi: 10.1111/tri.13089. Epub 2017 Nov 16. Transpl Int. 2018. PMID: 29090502 Review.
Cited by
- Endoscopic management of benign biliary strictures: Looking for the best stent to place.
Colombo M, Forcignanò E, Da Rio L, Spadaccini M, Andreozzi M, Giacchetto CM, Carrara S, Maselli R, Galtieri PA, Pellegatta G, Capogreco A, Massimi D, Khalaf K, Hassan C, Anderloni A, Repici A, Fugazza A. Colombo M, et al. World J Clin Cases. 2023 Nov 6;11(31):7521-7529. doi: 10.12998/wjcc.v11.i31.7521. World J Clin Cases. 2023. PMID: 38078147 Free PMC article. Review. - Antimigration versus conventional fully covered metal stents in the endoscopic treatment of anastomotic biliary strictures after deceased-donor liver transplantation.
Fuentes-Valenzuela E, de Benito Sanz M, García-Pajares F, Estradas J, Peñas-Herrero I, Durá-Gil M, Carbajo AY, de la Serna-Higuera C, Sanchez-Ocana R, Alonso-Martín C, Almohalla C, Sánchez-Antolín G, Perez-Miranda M. Fuentes-Valenzuela E, et al. Surg Endosc. 2023 Sep;37(9):6975-6982. doi: 10.1007/s00464-023-10199-3. Epub 2023 Jun 21. Surg Endosc. 2023. PMID: 37344754 - Post-ERCP pancreatitis occurs more frequently in self-expandable metallic stents than multiple plastic stents on benign biliary strictures: a meta-analysis.
Yang H, Yang Z, Hong J. Yang H, et al. Ann Med. 2022 Dec;54(1):2439-2449. doi: 10.1080/07853890.2022.2105395. Ann Med. 2022. PMID: 36799364 Free PMC article. - Covered Self-Expanding Metal Stents Versus Multiple Plastic Stents for Benign Biliary Strictures: An Updated Meta-Analysis of Randomized Controlled Trials.
Giri S, Jearth V, Sundaram S. Giri S, et al. Cureus. 2022 Apr 29;14(4):e24588. doi: 10.7759/cureus.24588. eCollection 2022 Apr. Cureus. 2022. PMID: 35651420 Free PMC article. Review.
References
- Kochhar G, Parungao JM, Hanouneh IA, et al. Biliary complications following liver transplantation. World J Gastroenterol 2013; 19: 2841.
- Arain MA, Attam R, Freeman ML. Advances in endoscopic management of biliary tract complications after liver transplantation. Liver Transpl 2013; 19: 482.
- Kao D, Zepeda-Gomez S, Tandon P, et al. Managing the post-liver transplantation anastomotic biliary stricture: multiple plastic versus metal stents: a systematic review. Gastrointest Endosc 2013; 77: 679.
- Tringali A, Barbaro F, Pizzicannella F, et al. Endoscopic management with multiple plastic stents of anastomotic biliary stricture following liver transplantation: long-term results. Endoscopy 2016; 48: 546.
- Cantù P, Tarantino I, Baldan A, et al. Endo-therapies for biliary duct-to-duct anastomotic stricture after liver transplantation: outcomes of a nationwide survey. Liver Int 2018; 39: 1355.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials
Miscellaneous