ENDOSCOPIC MANAGEMENT OF MALIGNANT BILIARY STRICTURES - RAFH EXPERIENCE

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.