Expandable metallic endoprostheses for biliary obstruction.
Expandable metal stents (20 Gianturco Z-stents and 1 Strecker stent deployed through 8.5 F sheaths) were used with initial success for palliating bile duct obstruction in 10 patients, 8 with malignant and 2 with benign strictures. Short-term failure occurred in one patient after 2 weeks, one died of unrelated causes after 10 days, and one remained jaundiced due to fulminant liver metastases. In the remaining 7 patients the obstruction was markedly palliated, with normalization of the serum bilirubin. Four have died without recurrent bile duct obstruction after a mean of 5.9 months, the 2 with benign strictures are well after 4 and 7 months, and one patient is presently palliated with a plastic endoprosthesis following reocclusion after 4 months. Expandable stents were easier to insert than conventional percutaneous endoprostheses of plastic polymers, and had longer patency in several patients, but reocclusion by tumor growth remains a constant threat in malignant disease. Metallic stents may be the therapy of choice in recurrent benign strictures, although the definitive conclusion needs longer observation and larger materials.
Mygind
T
T
Department of Radiology, Herlev Hospital, University of Copenhagen, Denmark.
Hennild
V
V
D000328:Adult; D000368:Aged; D002779:Cholestasis / Q000628:therapy*; D005260:Female; D006801:Humans; D008670:Metals; D008875:Middle Aged; D019736:Prostheses and Implants; D015607:Stents
D008670:Metals