Use of proton pump inhibitors (PPIs) is associated with a need for more subsequent biliary drainage procedures in patients with malignant biliary strictures treated with a self-expanding metal stent (SEMS)

Abstract

In patients with advanced malignancy, the role of SEMS placement is to provide patency of the biliary tree for the duration of the patient's limited life span. Several factors including microbial colonization, tissue hyperplasia, and tumor ingrowth have been hypothesized to cause biliary endoprothesis occlusion. While PPIs can alter the normal gastroduodenal acid physiology and may lead to small bowel bacterial overgrowth, it is unknown whether this can result promote biliary SEMS occlusion.