Objective: To evaluate endoscopic management in patients with malignan
t biliary strictures. Design: Retrospective study of all patients with
malignant biliary strictures, who had endoscopic diagnosis and/or man
agement between 1980 and 1993. Subjects: During 14 years, 123 patients
with malignant biliary strictures, had endoscopic diagnosis and manag
ement at the Gastroenterology Department, Armed Forces Hospital, Riyad
h. interventions: All patients had diagnostic endoscopic retrograde ch
olangiopancreatography (ERCP) and if possible sphincterotomy, nasobili
ary tube insertion or biliary structure dilatation and stent insertion
to relieve biliary obstruction. Some patients were referred for surge
ry. Results: Of these patients, 68 had cholangiocarcinoma, nine had ga
ll bladder carcinoma, 16 had pancreatic head carcinoma, 23 had papilla
ry carcinoma and seven had metastatic carcinoma. In 73 patients, bilia
ry drainage was achieved endoscopically using nasobiliary tubes in 26
patients, plastic stents in 37 patients and expandable metal stents in
10 patients. In 13 patients only sphincterotomy or endoscopic choledo
choduodenostomy were done. In the remaining 37 patients only diagnosti
c ERCP was done but endoscopic drainage was not possible and they were
referred for surgery.