AUTHOR=Bock Jonathan , Reisenauer Christopher J. , Jundt Michael C. , Augustine Matthew R. , Frimpong Richard G. , Takahashi Edwin A. 

TITLE=Complications of percutaneously placed uncovered metallic biliary stents for malignant obstruction: a systematic review

JOURNAL=Frontiers in Radiology

VOLUME=Volume 5 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/radiology/articles/10.3389/fradi.2025.1639323

DOI=10.3389/fradi.2025.1639323

ISSN=2673-8740

ABSTRACT=BackgroundThe 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. MethodsThis 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”.ResultsA total of 1,453 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.ConclusionIn 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.