In the first study, 291 patients with common bile duct obstruction were randomized into three different groups. Recurrent obstruction occurred in 43 percent of patients in the plastic stent group, 16 percent of the partially covered self-expanding metal stent group and 15 percent of uncovered self-expanding metal stent group. The initial cost of placement for plastic stents was lower, but the overall price was approximately $9,200, as opposed to $8,900 for metal stents.
In the second study, 63 patients with biliary obstruction associated with periampullary tumor scheduled for resection were randomized into two different groups. Researchers found a 25 percent complication rate in a group of patients with plastic stents and an 8.7 percent complication rate in patients with partially covered self-expanding metal stents.
The others concluded that metal stent placement is acceptable, but actual cost-savings will be determined by the payer.
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