title: [Endoscopic drainage with polyethylene endoprosthesis of malignant obstructive jaundice].
abstract: OBJECTIVE
  To evaluate the efficacy and complications of endoscopic drainage of malignant obstructive jaundice with plastic endoprosthesis as well as to identify possible factors related with occlusion.
  
  
  METHODS
  One-hundred and forty patients with malignant obstructive jaundice were retrospectively evaluated. The site of obstruction was proximal in 35 patients (25.0%), distal in 64 (45.7) and ampullary in 41 (29.3). Amsterdam or pigtail polyethylene prostheses of variable caliber and length were used. Drainage was preoperative in 41 patients and palliative in 99. Seventy-seven patients who underwent with palliative drainage were followed up long-term.
  
  
  RESULTS
  Drainage was satisfactory in 132 patients (94.2%). Early morbidity was 10.7% (14/140) and early mortality related with the technique was 5% (7/140). Time free of obstruction was 4.6 +/- 1.0 months and in 47/77 (60%) the prostheses were still working at the end of follow-up. The actuarial rate of obstruction at 6 months was 42%, the majority (61%) occurring in the first 3 months. The median survival was 5.9 +/- 1.3 months. Of all the factors analyzed, greater permeability was found only in the ampullary tumors (p < 0.01) and in prostheses of caliber equal or superior to 10 French (p < 0.01).
  
  
  CONCLUSIONS
  Endoscopic biliary drainage using plastic prostheses is satisfactory in the majority of patients with malignant jaundice. It has a low complication rate and provides acceptable palliation: the majority of patients do not require prostheses to be replaced and, when they becomes clogged, substitution usually solves the problem. Ampullary tumors and prostheses of higher caliber (> or = 10F) have been associated with greater permeability.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Regional Universitario Reina Sofía, Córdoba.
authors.forename: A
authors.initials: A
authors.lastname: Naranjo Rodríguez
authors.forename: J
authors.initials: J
authors.lastname: Puente Gutiérrez
authors.forename: A
authors.initials: A
authors.lastname: Hervás Molina
authors.forename: J F
authors.initials: JF
authors.lastname: de Dios Vega
authors.forename: A
authors.initials: A
authors.lastname: Monrobel Lancho
authors.forename: A
authors.initials: A
authors.lastname: González Galilea
authors.forename: G
authors.initials: G
authors.lastname: Miño Fugarolas
mesh_terms: D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000150:complications*; D002779:Cholestasis / Q000209:etiology* / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation* / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D020959:Polyethylene; D019736:Prostheses and Implants; D012189:Retrospective Studies
chemical_list: D020959:Polyethylene
vernacular_title: Drenaje endoscópico mediante prótesis de polietileno de la ictericia obstructiva maligna.