Percutaneous Transhepatic Metal Versus Plastic Stent Implantation For Treating Malignant Biliary Obstruction:Influence Factors Of Clinical Effecacy And Cost-effectiveness Analysis(A Multiple Center Research)

Percutaneous transhepatic metal versus plastic stent implantation for treating malignant biliary obstruction: Influence factors of clinical efficacy and cost-effectiveness analysis (A multiple center research) Postgraduate Guo Yuanxing Tutor prof Li Yanhao ABSTRACT Objective To compare metal versus plastic stent implantation for treating malignant biliary obstruction in clinical efficacy ~. influence factors of patients survival stents patency period and cost-effectiveness ratio(CER). Methods Percutaneous transhepatic self-expandable metal stent(n~6 1 ,group A) or 1OF plastic stent(n~34,group B) implantation were performed in 95 patients with malignant biliary obstruction in three hospitals of Guangdong province.AIl patients were followed up until death or at least one year after the procedure. Kaplan-Meier analysis was used to compare patients survival and stent patency rates. Twenty-two influence factors were analyzed by Ccx? s proportional hazard model .CERs of two groups were calculated.The main indexes were CER survival period (total cost/median survival period), CER patency period (total cost/median patency period). Results 30d mortality rate was lower in the group A(6/ 61, 9.8%)than group B (9 / 34, 26.5%, P0.05). CER in group A was lower than in group B(CER survival period ~237.4 yuan /d vs 452.6 yuan Id, CER patency period 231.2 yuan /d vs 472.9 yuan /d).Conclusion The stent type sex and tumor size are main influence factors for patients survival and stents patency period. The metal stent implantation is superior to the plastic stent in both of the clinical efficacy and CER for treatment of malignant biliary obstruction.