SYSTEMATIC REVIEW article
Front. Radiol.
Sec. Interventional Radiology
Volume 5 - 2025 | doi: 10.3389/fradi.2025.1639323
This article is part of the Research TopicThe Multifaceted Role of Cholangiocytes in Neoplastic and Non-Neoplastic Cholangiopathies: From Bench to BedsideView all 3 articles
Complications of Percutaneously Placed Uncovered Metallic Biliary Stents for Malignant Obstruction: A Systematic Review
Provisionally accepted
Jonathan Bock
Christopher J Reisenauer
Michael C JundtMatthew R AugustineRichard G Frimpong
Edwin A Takahashi*- Mayo Clinic, Rochester, United States
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The 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. This 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”. A total of 1453 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. In 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.
Keywords: bile duct, Biliary stent, Malignant biliary obstruction, complications, outcomes
Received: 01 Jun 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Bock, Reisenauer, Jundt, Augustine, Frimpong and Takahashi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Edwin A Takahashi, Mayo Clinic, Rochester, United States
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