Metallic stents in malignant biliary obstruction |
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Authors: | Andrea Rieber Hans-Jürgen Brambs |
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Institution: | (1) Department of Diagnostic Radiology, University of Ulm, Robert-Koch-Strasse 8, D-89075 Ulm, Germany |
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Abstract: | Purpose Retrospective analysis of our results with metallic stent placement for malignant biliary strictures. We sought to determine
parameters that influence stent patency.
Methods A total of 95 Wallstents were implanted in 65 patients (38 men, 27 women; mean age, 65.1 years) with malignant biliary obstruction.
Serum bilirubin levels were assessed in 48 patients; the mean value prior to intervention was 15.0 mg/dl.
Results In 12 patients (21%) complications occurred as a result of percutaneous transhepatic drainage. Stent implantation was complicated
in 13 patients, but was possible in all patients. A significant decrease in bilirubin level was seen in 83.3% of patients
following stent implantation. Approximately 30% of patients developed recurrent jaundice after a mean 97.1 days. In 9 patients
(15%) the recurrent jaundice was caused by stent occlusion due to tumor growth. The mean follow-up was 141.8 days, the mean
survival 118.7 days. Patients with cholangiocarcinomas and gallbladder carcinomas had the best results. Worse results were
seen in patients with pancreatic tumors and with lymph node metastases of colon and gastric cancers.
Conclusions The main predictive factors for occlusion rate and survival are the type of primary tumor, tumor stage, the decrease in bilirubin
level, and the general condition of the patient. |
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Keywords: | Metallic stents Malignant biliary obstruction Bile duct tumors |
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