Treatment of benign biliary strictures in chronic pancreatitis by self-expandable metal stents.
OBJECTIVE
To determine the efficacy the value of self-expandable metal stents in patients with benign biliary strictures caused by chronic pancreatitis.


METHODS
61 patients with symptomatic common bile duct strictures caused by alcoholic chronic pancreatitis were treated by interventional endoscopy.


RESULTS
Initial endoscopic drainage was successful in all cases, with complete resolution of obstructive jaundice. Of 45 patients who needed definitive therapy after a 12-months interval of interventional endoscopy, 12 patients were treated with repeated plastic stent insertion (19.7%) or by surgery (n = 30; 49.2%). In 3 patients a self-expandable metal stent was inserted into the common bile duct (4.9%). In patients treated with metal stents, no symptoms of biliary obstruction occurred during a mean follow-up period of 37 (range 18-53) months. The long-term success rate of treatment with metal stents was 100%.


CONCLUSIONS
Endoscopic drainage of biliary obstruction by self-expandable metal stents provides excellent long-term results. To identify patients who benefit most from self-expandable metal stent insertion, further, prospective randomized studies are necessary.
Kahl
Stefan
S
Department of Gastroenterology, Otto von Guericke University, Magdeburg, Germany.
Zimmermann
Sandra
S
Glasbrenner
Bernhard
B
Pross
Matthias
M
Schulz
Hans-Ulrich
HU
McNamara
Deirdre
D
Malfertheiner
Peter
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001651:Cholestasis, Extrahepatic / Q000209:etiology / Q000628:therapy*; D002908:Chronic Disease; D003137:Common Bile Duct Diseases / Q000209:etiology / Q000628:therapy*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D019512:Pancreatitis, Alcoholic / Q000150:complications*; D015607:Stents
D008670:Metals