| Summary: | Background: There is no consensus regarding optimal management of biliary metal stent occlusion.
Aim: To evaluate the efficacy of different percutaneous methods for managing biliary metal stent occlusion.
Patients and methods: Thirty-eight patients were included in the study. Metal biliary stent occlusions were managed by insertion of another metal stent in 18 patients (group 1), insertion of an internal–external catheter in 15 patients (group 2), and mechanical cleaning in 5 patients (group 3).
Results: The clinical success was achieved with bilirubin decreased from 16.0 (7.5–34.3) to 4.1 (1.2–5.7) mg/dl (p < 0.05) with no significant differences among all groups. No major complications occurred. The median duration of metal stent patency was 75 days (43–107) after insertion of another metal stent (group 1), 90 days (71–109) after insertion of plastic internal–external catheters (group 2), and 54 days (30–68) after mechanical cleaning (group 3) with no significant difference. Incremental cost effective analysis showed that plastic internal–external catheters insertion is the most cost effective option.
Conclusion: Although the three methods are equally effective in managing an occluded metal stent, the most cost effective method appears to be plastic internal–external catheters insertion.
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