Post written by Mitsuru Okuno, MD, PhD, from the Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan.

We reported on the evaluation of ursodeoxycholic acid (UDCA) for different self-expandable metal stent (SEMS) types in malignant distal biliary obstruction (MDBO) with a multicenter retrospective study design using propensity score—matched cohort analysis.

The non-UDCA group had significantly longer stent patency and time to recurrent biliary obstruction (TRBO) than those in the UDCA group (528 vs 154 days, P = .0381).

In the multivariate analysis, UDCA administration was identified as the independent risk factor for reducing TRBO (hazard ratio, 2.28; 95% confidence interval, 1.06-4.88; P = .0348). There was no significant difference in the rate of adverse events between groups.

The efficacy of UDCA for SEMSs is a pertinent clinical question. Therefore, this retrospective study aimed to evaluate the efficacy of UDCA in patients with SEMSs for MDBO using a propensity score—matched cohort analysis.

The cumulative SEMS occlusion rate was 41.8% and 18.2% in the groups with and without UDCA, respectively (P = .0119). To our knowledge, administering UDCA after SEMSs was not efficacious for prolonging TRBO in MDBO.

Moreover, administering UDCA beyond a month might increase the risk of stent sludge occlusion.

Kaplan-Meier curves of time to recurrent biliary obstruction (TRBO) in the control and ursodeoxycholic acid (UDCA) groups of the propensity score–matched cohort. The median TRBO was significantly longer in the control group (528 days) than in the UDCA group (154 days; P = .0381 by log-rank test).

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