Stenting as a definitive procedure in benign biliary disease.
OBJECTIVE
To assess the efficacy of biliary stent insertion for benign disease.


METHODS
A five year review of all patients who underwent endoscopic retrograde cholangio-pancreatography (ERCP). Those who had a stent inserted for benign biliary disease were retrospectively analysed by chart review, family doctor contact and death certificate checking.


METHODS
A large district general hospital providing an ERCP service for 200,000 people.


METHODS
Thirty-one patients (mean age 75) were identified who had biliary endoprostheses inserted for unextractable stones (20) solitary stricture (3) or both (8).


RESULTS
Complications requiring stent change and stent-related death were the clinical measurements recorded. Serum bilirubin and alkaline phosphatase were also measured.


RESULTS
Ten (32%) patients died a mean of 12 months after the procedure. One stricture patient died from causes related to the biliary tract. The remaining 21 patients were followed for a mean of 29 months and all are asymptomatic. Complications developed in 6 patients a stricture being present at initial stenting in 5 of these six patients. Requirement for further procedures was statistically more frequent in patients with stricturing (45% v 5% p < 0.05). Although initially, no different alkaline phosphatase levels on latest follow-up were significantly higher in patients who had a stricture at initial ERCP (512 v 176 p < 0.005).


CONCLUSIONS
Stenting for unextractable biliary stones in patients judged unfit for surgery is a safe and effective procedure. Stenting in the presence of biliary strictures carries a significantly greater risk of future complications.
Johnston
B T
BT
Altnagelvin Area Hospital, Londonderry, N. Ireland.
O'Connor
F A
FA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents