[Clinical application of expandable metal stent for palliation of malignant biliary obstruction].
OBJECTIVE
To investigated the long-term result of expandable metallic biliary stent implantation and evaluated preliminarily the factors that might impact the therapeutic effectiveness.


METHODS
134 patients with malignant choledochal stenosis were treated with metallic endo-prosthesis (128 transpapillary endoscopically and 6 transhepatic percutaneously). The follow-up results were compared with those of 97 patients with conventional plastic stents during the same period.


RESULTS
The success rate was 95.7%, and the procedure related complications were found in 6.4% of patients. The jaundice was eliminated completely in 85.6% patients. During long-term follow-up, the metal stents were shown patent for a mean duration of 300 days, which was significantly longer than 80 days of polyethylene endoprostheses (P < 0.01). The mean survival was 210 days. From classified data assessment, the stent patency in primary bile duct neoplasm group was almost similar to that in metastatic group, but the median survival of the former was slightly longer than that of the latter. There were flow differences in patancy and survival rates between the hilar obstruction group and the middle and low obstruction group.


CONCLUSIONS
The median patancy of expandable metal stents was significantly longer than that of conventional plastic prostheses. To get the highest benefit, however, the indication should be strictly selected.
Hu
B
B
Orient Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438.
Zhou
D
D
Gong
B
B
Qian
G
G
Chen
H
H
Wu
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
D008670:Metals