Palliation of malignant obstructive jaundice. Use of self-expandable metal stents.
OBJECTIVE
The aim of this study was to analyze the clinical efficacy of metal stents in the palliation of malignant obstructive jaundice.


METHODS
Fifty patients with malignant biliary obstruction were palliated by means of drainage with a metallic self-expandable stent (Wallstent). Nineteen patients had pancreatic carcinoma, 22 cholangiocarcinoma, 4 hepatocellular carcinoma, and the remaining 5 metastatic carcinoma from a variety of primary sites. The obstruction was at the level of the liver hilum in 19 cases, in the middle common bile duct in 11, and in the lower common bile duct in 20.


RESULTS
The patients were followed over a period of 1-17 months. A total of 36 patients (72%) died; 14 (28%) survived. The mean observation time for the whole group of 50 patients was 3.3 months. The 30-day mortality rate was 14% (7 patients). Short-term complications occurred in 6 patients (12%). Long-term complications included stent occlusion requiring a 2nd intervention in 2 patients (4%), and cholangitis in 2 patients (4%). Excellent palliation was achieved in most of the patients. No stent migration was observed.


CONCLUSIONS
The metallic stent provides good palliative drainage, and the percutaneous insertion of metallic stents is well tolerated by the patients. The procedure is simple and safe to use and can be executed in one stage. The one-stage procedure, compared to the 2-stage procedure, may reduce hospital stays.
Men
S
S
Department of Radiology, Social Security Hospital, Ankara, Turkey.
Hekimoglu
B
B
Kaderoglu
H
H
Pinar
A
A
Conkbayir
I
I
Soylu
S O
SO
Bulut
A
A
Yandakçi
K
K
Baran
I
I
Aran
Y
Y
D001650:Bile Duct Neoplasms / Q000150:complications; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000150:complications; D018281:Cholangiocarcinoma / Q000150:complications; D001651:Cholestasis, Extrahepatic / Q000209:etiology / Q000628:therapy*; D003137:Common Bile Duct Diseases / Q000209:etiology / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000150:complications; D015641:Radiography, Interventional; D013193:Stainless Steel; D015607:Stents; D016896:Treatment Outcome
D013193:Stainless Steel