[Endoscopic palliative treatment of the common bile duct at the hepatic hilum. Results in 583 patients treated in a single center over a 10-year period].
BACKGROUND
The outcomes of endoscopic biliary drainage for malignant stenoses at the hepatic hilum were retrospectively evaluated.


METHODS
From January 1990 to June 2001, 583 patients, 368 males, average age 69+/-18.5 years, were recruited. Endoscopic procedure consisted of insertion of 1 ore multiple stents, plastic or metallic, across the stricture, under mild sedation.


RESULTS
Successful stent insertion was achieved in 518/583 (88.8%) patients and successful drainage in 474 (81.3%) patients. Early complications were observed in 101 (17.3%) patients with related-mortality of 17 (2.9%) patients. Late complications occurred in 39.9% of patients. Survival was of 189 days, on average.


CONCLUSIONS
Endoscopic palliation should be the initial management of choice for malignant biliary stenoses at the hepatic hilum.
Dipartimento di Chirurgia Generale, Oncologica ed Endoscopia Digestiva, Università degli Studi Federico II, Napoli, Italy. gdepalma@arrotino.it
G D
GD
De Palma
F
F
Persico
S
S
Masone
O
O
Labianca
L
L
Mastantuono
M
M
Di Marino
G
G
Persico
D000368:Aged; D000369:Aged, 80 and over; D018281:Cholangiocarcinoma / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D001651:Cholestasis, Extrahepatic / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D003135:Common Bile Duct / Q000473:pathology / Q000601:surgery*; D003251:Constriction, Pathologic; D004322:Drainage; D005260:Female; D005706:Gallbladder Neoplasms / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents / Q000706:statistics & numerical data*