Percutaneous metallic self-expandable endoprostheses in biliary obstruction caused by metastatic cancer.
OBJECTIVE
Up to now, all reports about metallic stents concerned mostly patients with obstructive jaundice due to primary cancer although some of these series included a small number of patients with metastatic disease as a cause of occlusion of the bile ducts. The question of whether they should be used in patients with biliary obstruction due to metastatic disease, and consequently have a limited life expectancy, is investigated.


METHODS
Between January 1994 and April 1995, we inserted percutaneously 20 metallic self-expandable endoprostheses in 14 patients with obstructive jaundice due to metastatic disease.


RESULTS
Twelve patients died with a mean survival of 144.6 (range 25-338) days without any evidence of biliary reobstruction. For 2 patients, we have followup no longer than 30 days. Thirty day mortality was 7.2% (1/14). Jaundice reoccurred in one patient but wasn't related to stent obstruction, and he died during the first 30 days. We had 2 cases with moderate hemobilia.


CONCLUSIONS
We believe that the use of metal stents in patients with obstructive jaundice due to metastatic disease is justified. Their high initial cost is offset by their prolong patency, decreased complication rate and shorter hospitalization.
Kaskarelis
I S
IS
Department of Radiology, Regional General Hospital of Athens: Evangelismos, Greece.
Minardos
I A
IA
Abatzis
P P
PP
Malagari
K S
KS
Vrachliotis
T G
TG
Natsika
M K
MK
Kouris
S G
SG
Roubis
K G
KG
Vrachliotis
G T
GT
D000368:Aged; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000401:mortality / Q000556:secondary*; D008297:Male; D010166:Palliative Care; D011859:Radiography; D015607:Stents