ASO Author Reflections: Comparison Between Plastic and Metallic Biliary Stent Placement for Preoperative Patients with Pancreatic Head Cancer—A Systematic Review and Meta-analysis

Excerpt

Pancreatic cancer is a major cause of cancer-related death, and neoadjuvant treatment (NAT) has evolved to improve survival outcomes in borderline resectable or locally advanced cases.¹ Durable and secure preoperative biliary drainage (PBD) is necessary to ameliorate obstructive jaundice before surgery or NAT. Selecting a type of stent (i.e., metallic stent [MS] vs. plastic stent [PS]) in the preoperative setting has been a matter of debate, especially for patients treated with NAT. A longer stent patency period is required for 4–12 weeks before surgery among patients undergoing upfront surgery and much longer waiting time among patients receiving NAT, whereas local inflammation should be avoided to minimize surgical risk.² To identify which types of stents are optimal, several studies have compared MS with PS for resectable and borderline resectable PC. However, the patient populations in these studies were small, and the studies were retrospective and performed mostly at a single center. As such, in the current study, we sought to investigate the comparison between MS and PS in terms of endoscopic reintervention and perioperative complication rates in patients with PC who underwent subsequent surgery.³ …