Complications of percutaneously placed uncovered metallic biliary stents for malignant obstruction: a systematic review

BackgroundThe aim of this systematic review was to determine the patency and complications related to percutaneous metallic biliary stent placement for malignant biliary obstruction in the current literature. MethodsThis review was performed using the Preferred Reporting Items of Systematic Reviews...

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Main Authors: Jonathan Bock, Christopher J. Reisenauer, Michael C. Jundt, Matthew R. Augustine, Richard G. Frimpong, Edwin A. Takahashi
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Radiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fradi.2025.1639323/full
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author Jonathan Bock
Christopher J. Reisenauer
Michael C. Jundt
Matthew R. Augustine
Richard G. Frimpong
Edwin A. Takahashi
author_facet Jonathan Bock
Christopher J. Reisenauer
Michael C. Jundt
Matthew R. Augustine
Richard G. Frimpong
Edwin A. Takahashi
author_sort Jonathan Bock
collection DOAJ
description BackgroundThe aim of this systematic review was to determine the patency and complications related to percutaneous metallic biliary stent placement for malignant biliary obstruction in the current literature. MethodsThis review was performed using the Preferred Reporting Items of Systematic Reviews and Meta-Analyses guidelines. EMBASE and PubMed were queried yielding 891 articles, 18 of which were included in the final analysis. The Newcastle-Ottawa Quality Assessment Scale was used to appraise article quality. Patient demographics, technical success rate, and procedure outcomes were recorded. Complications were classified as “major” if they resulted in blood transfusion or additional invasive procedures or were reported as such in the literature. Complications that did not meet these criteria were classified as “minor”.ResultsA total of 1,453 patients (677 female; weighted age 66.8 years) underwent biliary stent placement. The weighted technical success rate was 97.7%. The incidence of stent occlusion was 13.5% with 6.6% of patients requiring further intervention to maintain patency. There were 277 (19.1%) complications, of which 87 were classified as major. The most common complications were pancreatitis (93, 6.4%), cholangitis (69, 4.8%), and bleeding (64, 4.4%). In cases of bleeding, 4.7% of patients needed a blood transfusion and 15.6% required a procedure to treat bleeding. There were 6 (0.4%) procedure-related deaths.ConclusionIn conclusion, percutaneous metallic stent placement for malignant biliary obstruction has a high technical success rate and relatively low rate of occlusion. Although nearly one in five procedures resulted in a complication, most cases were minor.
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spelling doaj-art-33c5c19616834d07b7eb3902a8ef46bd2025-08-20T04:00:40ZengFrontiers Media S.A.Frontiers in Radiology2673-87402025-08-01510.3389/fradi.2025.16393231639323Complications of percutaneously placed uncovered metallic biliary stents for malignant obstruction: a systematic reviewJonathan Bock0Christopher J. Reisenauer1Michael C. Jundt2Matthew R. Augustine3Richard G. Frimpong4Edwin A. Takahashi5Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, MN, United StatesDepartment of Radiology, Division of Vascular and Interventional Radiology, Mayo Clinic, Rochester, MN, United StatesDepartment of Radiology, Division of Vascular and Interventional Radiology, Mayo Clinic, Rochester, MN, United StatesDepartment of Radiology, Division of Vascular and Interventional Radiology, Mayo Clinic, Rochester, MN, United StatesDepartment of Radiology, Division of Vascular and Interventional Radiology, Mayo Clinic, Rochester, MN, United StatesDepartment of Radiology, Division of Vascular and Interventional Radiology, Mayo Clinic, Rochester, MN, United StatesBackgroundThe aim of this systematic review was to determine the patency and complications related to percutaneous metallic biliary stent placement for malignant biliary obstruction in the current literature. MethodsThis review was performed using the Preferred Reporting Items of Systematic Reviews and Meta-Analyses guidelines. EMBASE and PubMed were queried yielding 891 articles, 18 of which were included in the final analysis. The Newcastle-Ottawa Quality Assessment Scale was used to appraise article quality. Patient demographics, technical success rate, and procedure outcomes were recorded. Complications were classified as “major” if they resulted in blood transfusion or additional invasive procedures or were reported as such in the literature. Complications that did not meet these criteria were classified as “minor”.ResultsA total of 1,453 patients (677 female; weighted age 66.8 years) underwent biliary stent placement. The weighted technical success rate was 97.7%. The incidence of stent occlusion was 13.5% with 6.6% of patients requiring further intervention to maintain patency. There were 277 (19.1%) complications, of which 87 were classified as major. The most common complications were pancreatitis (93, 6.4%), cholangitis (69, 4.8%), and bleeding (64, 4.4%). In cases of bleeding, 4.7% of patients needed a blood transfusion and 15.6% required a procedure to treat bleeding. There were 6 (0.4%) procedure-related deaths.ConclusionIn conclusion, percutaneous metallic stent placement for malignant biliary obstruction has a high technical success rate and relatively low rate of occlusion. Although nearly one in five procedures resulted in a complication, most cases were minor.https://www.frontiersin.org/articles/10.3389/fradi.2025.1639323/fullbile ductbiliary stentmalignant biliary obstructioncomplicationsoutcomes
spellingShingle Jonathan Bock
Christopher J. Reisenauer
Michael C. Jundt
Matthew R. Augustine
Richard G. Frimpong
Edwin A. Takahashi
Complications of percutaneously placed uncovered metallic biliary stents for malignant obstruction: a systematic review
Frontiers in Radiology
bile duct
biliary stent
malignant biliary obstruction
complications
outcomes
title Complications of percutaneously placed uncovered metallic biliary stents for malignant obstruction: a systematic review
title_full Complications of percutaneously placed uncovered metallic biliary stents for malignant obstruction: a systematic review
title_fullStr Complications of percutaneously placed uncovered metallic biliary stents for malignant obstruction: a systematic review
title_full_unstemmed Complications of percutaneously placed uncovered metallic biliary stents for malignant obstruction: a systematic review
title_short Complications of percutaneously placed uncovered metallic biliary stents for malignant obstruction: a systematic review
title_sort complications of percutaneously placed uncovered metallic biliary stents for malignant obstruction a systematic review
topic bile duct
biliary stent
malignant biliary obstruction
complications
outcomes
url https://www.frontiersin.org/articles/10.3389/fradi.2025.1639323/full
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