To compare efficacy and safety of self-expandable metallic stent (SEMS) placement and catheter drainage for malignant bilioenteric anastomotic stricture (BAS).

This study included 33 patients with malignant BAS treated from March 2016 to June 2019. Nineteen patients underwent insertion of SEMS (Stent group); the remaining fourteen patients underwent catheter drainage (Catheter group). Technical success was defined as successful placement of stent or drainage catheter in the appropriate position; clinical success was defined as 20% reduction in serum bilirubin within 1 week after the procedure, compared with baseline. Complications, duration to stent/catheter malfunction, and overall survival were evaluated.

Technical success was achieved in all patients in both groups. In the Stent group, 15 patients received one stent and the other 4 patients required two stents. Clinical success rates were similar between the groups [Stent group, 94.7% (18/19); Catheter group, 92.9% (13/14)]. There were no major complications. The median duration to stent/catheter malfunction was significantly longer in the Stent group (130 days) than that in the control group (61 days; P=0.001). The median overall survival was also significantly longer in the Stent group (159 days) than that in the Control group (65 days; P=0.003).

SEMS placement may be better than drainage catheter insertion for malignant BAS in terms of the duration before stent/catheter malfunction and patient survival.