Polyurethane-covered metal stent for management of distal malignant biliary obstruction.
BACKGROUND
The efficacy of polyurethane-covered metal expandable stents for treatment of neoplastic distal biliary obstruction was analyzed.


METHODS
Twenty-one patients with unresectable malignant tumors involving the mid to distal bile duct who were seen with obstructive jaundice were consecutively enrolled. Eighteen patients underwent endoscopic implantation of a polyurethane-covered metal stent and 3 patients underwent transhepatic insertion because of duodenal obstruction. The stent patency, complications, and patient survival were analyzed.


RESULTS
Effective biliary decompression was achieved in all patients. Adverse events were minor: mild pancreatitis (1) and cholecystitis (2) occurred within 7 days of stent insertion. Mean survival and stent patency were 233 days and 206 days, respectively. Stent occlusion occurred in 3 patients (14%) after a mean of 188 days. Tumor ingrowth through the stent mesh was not observed. However, 2 stents were occluded by tumor overgrowth and 1 by compacted alimentary debris.


CONCLUSIONS
A polyurethane membrane may prevent tumor ingrowth and reduce the occlusion rate for expandable metal stents implanted in patients with malignant obstruction of the distal bile duct.
Isayama
Hiroyuki
H
Department of Gastroenterology, Department of Endoscopy and Endoscopic Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, japan.
Komatsu
Yutaka
Y
Tsujino
Takeshi
T
Yoshida
Haruhiko
H
Tada
Minoru
M
Shiratori
Yasushi
Y
Kawabe
Takao
T
Omata
Masao
M
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000209:etiology / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000150:complications; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications; D011140:Polyurethanes; D015607:Stents; D016896:Treatment Outcome
D011140:Polyurethanes