Covered gianturco stents for malignant biliary obstruction: preliminary clinical evaluation.
OBJECTIVE
To evaluate the effectiveness of covered Gianturco stents in patients with malignant biliary obstruction.


METHODS
Three types of partially polyurethane-covered stents were implanted in 19 patients with malignant biliary obstruction located distal to the hilar confluence. A transhepatic approach was employed in all but one patient, in whom the stent was placed through a T-tube tract.


RESULTS
Stent placement was possible in all patients. In 15 patients, the implanted stents were expanded to a mean of 81% of their original diameter. In the remaining four patients, the stents expanded to less than 40% of the original diameter, and balloon dilation and additional bare stent placement were required. All patients except one, who had impairment of liver function due to multiple liver metastases, showed relief of jaundice after stent placement. At follow-up, which ranged from 5 to 57 weeks (mean, 24.7 weeks), one stent (5%) was occluded after 26 weeks due to tumor growth above the upper stent edge, and required secondary intervention. Complications in three patients included stent migration in one (5%) and cholangitis in two (11%).


CONCLUSIONS
Preliminary results suggest that placement of covered Gianturco stents is feasible, the complication rate is acceptable, and short-term patency appears promising.
Miyayama
S
S
Department of Diagnostic Radiology, Fukuiken Saisekai Hospital, Japan.
Matsui
O
O
Terayama
N
N
Tatsu
H
H
Yamamoto
T
T
Takashima
T
T
D000328:Adult; D000368:Aged; D002758:Cholangiography; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010166:Palliative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D012449:Safety; D015607:Stents / Q000009:adverse effects; D015996:Survival Rate; D016896:Treatment Outcome