Efficacy and safety of plastic and metal stents for endoscopic ultrasound guided-biliary drainage in elderly patients - Original Article

Sep 28, 2026

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Endoscopic ultrasound (EUS)-guided biliary drainage (BD) is increasingly used when endoscopic retrograde cholangiopancreatography is difficult, yet the optimal stent type for elderly patients remains unclear. A multicenter retrospective cohort analyzed patients aged 70 years or older who underwent successful EUS-BD, comparing metallic stents and plastic stents. Plastic stents showed sufficient outcomes for benign disease, while metallic stents were associated with longer time to recurrent biliary obstruction in malignant obstruction, reducing stent replacement needs.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

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| W | J | G | E | World Journal of
Gastrointestinal Endoscopy | | --- | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastrointest Endosc 2025 December 16; 17(12): 110136 DOI: 10.4253/wjge.v17.i12.110136 ISSN 1948-5190 (online) ORIGINAL ARTICLE Retrospective Cohort Study Efficacy and safety of plastic and metal stents for endoscopic ultrasound guided-biliary drainage in elderly patients Mitsuru Sugimoto, Yuki Nakajima, Yutaro Takeda, Yuki Sato, Tadayuki Takagi, Rei Suzuki, Hiroyuki Asama, Hiroshi Shimizu, Kentaro Sato, Rei Ohira, Jun Nakamura, Tsunetaka Kato, Takumi Yanagita, Mitsuru Otsuka, Takuto Hikichi, Hiromasa Ohira Specialty type: Gastroenterology and hepatology Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B, Grade C, Grade C, Grade C, Grade C Novelty: Grade B, Grade B, Grade C, Grade D, Grade D Creativity or Innovation: Grade B, Grade B, Grade C, Grade C, Grade C Scientific Significance: Grade B, Grade B, Grade C, Grade C, Grade E P-Reviewer: Chiba M, MD, Japan; Morozov S, PhD, Professor, Russia; Yuksel I, MD, Professor, Türkiye Received: June 4, 2025 Revised: June 28, 2025 Accepted: November 4, 2025 Published online: December 16, 2025 Processing time: 200 Days and 1.8 Hours Mitsuru Sugimoto, Yuki Sato, Tadayuki Takagi, Rei Suzuki, Hiroyuki Asama, Hiroshi Shimizu, Kentaro Sato, Rei Ohira, Takumi Yanagita, Mitsuru Otsuka, Department of Gastroenterology, Fukushima Medical University, Fukushima 960-1295, Japan Yuki Nakajima, Department of Gastroenterology, Aizu Medical Center Fukushima Medical University, Aizuwakamatsu 969-3492, Fukushima, Japan Yutaro Takeda, Department of Gastroenterology, Ohtanishinouchi General Hospital, Koriyama 963-8558, Japan Jun Nakamura, Tsunetaka Kato, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 960-1295, Japan Takuto Hikichi, Department of Endoscopy, Fukushima Medical University, Fukushima 960- 1295, Japan Hiromasa Ohira, Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 960-1295, Japan Corresponding author: Mitsuru Sugimoto, MD, PhD, Assistant Professor, Department of Gastroenterology, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan. [kitachuuou335@yahoo.co.jp](kitachuuou335@yahoo.co.jp) Abstract BACKGROUND Endoscopic ultrasound (EUS)-guided biliary drainage (BD) is becoming more common as a secondary drainage method in cases of difficult endoscopic retrograde cholangiopancreatography. In a recent study, EUS-BD reportedly demonstrated similar safety between elderly patients and all other patients. However, the appropriate stent for placement in elderly patients is unknown. AIM To clarify whether a metallic stent (MS) or a plastic stent (PS) is suitable when performing EUS-BD in elderly patients. WJGE [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 16, 2025 Volume 17 Issue 12 Sugimoto M et al. Stent for EUS-BD in elderly patients METHODS This was a multicenter retrospective study of patients who underwent EUS-BD between March 2005 and February 2025. The data of patients aged 70 years or older who underwent successful EUS-BD were analyzed, and the longterm outcomes of patients treated with an MS (MS group) and those treated with a PS (PS group) were compared. RESULTS Ninety-four patients underwent successful EUS-BD, of whom 64 were aged 70 years or older. The PS group included 51 patients, and the MS group included 13 patients. The time to recurrent biliary obstruction (TRBO) was not significantly different between the PS group and the MS group (6-month recurrent biliary obstruction rate 50.8% vs 26.8%, P = 0.18) . When patients were limited to those with malignancies without antegrade stenting, the TRBO was significantly lo

FAQs

What is the study's main aim regarding stents for elderly patients?

To determine whether metallic stents or plastic stents are more suitable for EUS-guided biliary drainage in elderly patients.

How was the study conducted?

A multicenter retrospective study compared outcomes between patients receiving metallic stents (MS group) and plastic stents (PS group) among those aged 70 years or older who had successful EUS-BD.

What were the key findings for benign versus malignant biliary disease?

For benign biliary disease, plastic stents were considered sufficient because they are easier to replace. For malignant biliary obstruction, metallic stents appeared more effective, with a longer time to recurrent biliary obstruction and reduced need for stent replacement.

Sep 28, 2026

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