Abstract
Metal endoprostheses of the Wallstent type were successfully inserted percutaneously and endoscopically in 80 consecutive patients with malignant obstructive biliary stenoses, who were followed for up to 18 months. The indication for treatment was jaundice due to malignant biliary obstruction. Repeat radiological investigations were performed if the patient had symptoms suggesting stent occlusion. After stent implantation, 88% of patients demonstrated a serum bilirubin decrease by more than 50%. We observed a 15% rate of serious complications, including a 10% rate of cholangitis with septicemia. There were no cases of stent migration or occlusion due to encrustation of bile. Recurrent jaundice occurred in 17.5% of patients due to progressive tumor growth after 3–10 months. In 5 of these patients, tumor overgrowth was redilated and/or restented. Of the 80 patients, 34% are alive after 2–12 months (mean: 242 days); of these, two-thirds are free of jaundice. Sixty-six percent of patients died between 3 days and 1.5 years (mean: 133 days). Although autopsy investigations revealed the possibility of tumor growth onto the inner surface of the stent, through the mesh of the endoprosthesis, no stent occlusion by tumor ingrowth into the lumen occurred. Self-expandable stainless steel endoprostheses provide good palliation in patients with malignant obstructive jaundice.
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References
Coons HG (1989) Self-expanding stainless steel biliary stents. Radiology 170:979–983
Gillams A, Dick R, Dooley JS, Wallsten H, El-Din A (1990) Self-expandable stainless steel braided endoprosthesis for biliary strictures. Radiology 174:137–140
Huibregtse K, Cheng J, Coene PPLO, Fockens P, Tytgat GNJ (1989) Endoscopic placement of expandable metal stents for biliary strictures—A preliminary report on experience with 33 patients. Endoscopy 21:280–282
Irving JD, Adam A, Dick R, Dondelinger RF, Lunderquist A, Roche A (1989) Gianturco expandable metallic biliary stents: Results of a European clinical trial. Radiology 172:321–326
McLean GK, Burke DR (1989) Role of endoprostheses in the management of malignant biliary obstruction. Radiology 170:961–967
Rossi P, Bezzi M, Salvatori FM, Maccioni Francesca, Porcaro ML (1990) Recurrent benign biliary strictures: Management with self-expanding metallic stents. Radiology 175:661–665
Dick R, Gillams A, Dooley JS, Hobbs KEF (1989) Stainless steel mesh stents for biliary strictures. J Intervent Radiol 4:95–98
Neuhaus H, Hagenmüller F, Griebel M, Rotter M, Classen M (1990) Endoskopische und perkutane Implantation selbst-expan-dierender Endoprothesen bei biliären Stenosen. Dtsch Med Wschr 115:1299–1306
Zollikofer CL, Largiader I, Brühlmann WF, Uhlschmid GK, Marty AH (1988) Endovascular stenting of veins and grafts: Preliminary clinical experience. Radiology 167:707–712
Mueller PR, Ferrucci JT, Teplick SK, van Sonnenberg E, Haskin PH, Butch RJ, Papanicolaou N (1985) Biliary stent endoprosthesis: Analysis of complications in 113 patients. Radiology 156:637–639
Groen AKH, Out T, Huibregtse K, Delzenne B, Hoek FJ, Tytgat GNJ (1987) Characterization of the content of occluded biliary endoprostheses. Endoscopy 19:57–59
Leung JMV, Ling TKW, Kung JLS, Vallance-Owen J (1988) The role of bacteria in the blockage of biliary stents. Gastrointest Endos 34:19–22
Roeren T, Brambs HJ, Richter GM, Kauffmann GW (1990) Coated balloon-expandable stent for percutaneous treatment of malignant biliary obstruction. Radiology 177(B):238–239
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Salomonowitz, E.K., Adam, A., Antonucci, F. et al. Malignant biliary obstruction: Treatment with self-expandable stainless steel endoprosthesis. Cardiovasc Intervent Radiol 15, 351–355 (1992). https://doi.org/10.1007/BF02734117
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DOI: https://doi.org/10.1007/BF02734117