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Does heparin coating reduce encrustation of biliary plastic endoprostheses? A prospective randomized trial.

Abstract：

OBJECTIVE:Common bile duct stenting is widely performed for bridging benign and malignant obstructions. A major limitation is early stent occlusion making regular stent exchange necessary. Covalent binding of glycosaminoglycanes to polyethylene stents proved to reduce encrustation in urological implants. Since development of urological and biliary stent occlusion shows parallels, the aim of the study was to evaluate the efficacy of heparin coating of biliary endoprostheses in preventing encrustation. MATERIAL AND METHODS:In a prospective randomized trial, heparin-coated and native stents were endoscopically placed for almost 90 days on average. After removal, all stents were dried (50°C, 24 h), weighed and after longitudinal incision visible encrustation and discoloration recorded. Fifty-three patients (21 females/32 males, 70 ± 12 (42-87) years) were included; 13 patients (4 females/9 males, 58-79 years) completed the study according to the protocol. RESULTS:After removal, mean weight of encrustation in native stents was more than double as high as of covered stents (native: 37.9 ± 19.8 (16-93) mg; covered: 17.6 ± 6.7 (9-33) mg). In 12 of 13 cases, the encrustation weight of the native stent was higher than that of the corresponding covered stent in the same patient. Premature stent explantation became necessary in 3 of 13 native stents, because of recurrent jaundice or cholangitis but only in 1 of 13 covered stents. After longitudinal incision, the three uncovered stents showed excessive encrustation whereas no significant encrustation was found in the covered prosthesis. Altogether, covered stents showed less visible accumulation of clogging material and discoloration than native stents. CONCLUSIONS:Covalent bound heparin is highly effective in preventing encrustation of biliary polyethylene endoprostheses.

journal_name

Scand J Gastroenterol

journal_title

Scandinavian journal of gastroenterology

authors

Farnbacher MJ,Lederer R,Blana A,Schneider HT

doi

10.3109/00365521.2012.711849

subject

Has Abstract

pub_date

2012-10-01 00:00:00

pages

1141-7

issue

eissn

0036-5521

issn

1502-7708

journal_volume

pub_type

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Does heparin coating reduce encrustation of biliary plastic endoprostheses? A prospective randomized trial.