Efficacy and complications of covered Wallstents in malignant distal biliary obstruction.
BACKGROUND
This study evaluated the efficacy and the complications associated with the use of the covered Wallstent in the setting of unresectable malignant biliary obstruction.


METHODS
Between March 2001 and January 2003, all patients with distal malignant biliary obstruction that required drainage were treated with a covered Wallstent. Every 2 months, the patients were evaluated clinically and biochemical tests of liver function were obtained. Data were recorded for the following variables: early complications (within 30 days of stent placement), early and late stent occlusion, duration of stent patency, need for subsequent biliary intervention, and patient survival.


RESULTS
A total of 88 covered Wallstents were inserted in 80 patients. Stent patency rates at 3, 6, and 12 months were 90%, 82%, and 78%, respectively. Complications included stent migration (5), stent occlusion (12), episodes of cholecystitis (3), and episodes of post-ERCP pancreatitis (5). Biliary intervention was required in 9 patients subsequent to placement of the initial covered Wallstent.


CONCLUSIONS
Deployment of a covered Wallstent is safe and relatively easy. It achieves biliary drainage with an acceptable risk to benefit ratio in the majority of patients with distal malignant biliary obstruction.
Kahaleh
Michel
M
Digestive Health Center, Department of Biostatistics, University of Virginia Health System, Charlottesville, VA 22908-0708, USA.
Tokar
Jeffrey
J
Conaway
Mark R
MR
Brock
Andrew
A
Le
Tri
T
Adams
Reid B
RB
Yeaton
Paul
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D002779:Cholestasis / Q000209:etiology* / Q000601:surgery*; D004067:Digestive System Neoplasms / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications; D011471:Prostatic Neoplasms / Q000150:complications; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome