ENDOSCOPIC BILIARY ENDOPROSTHESIS FOR PALLIATION OF GALLBLADDER CARCINOMA

Background: Carcinoma of the gallbladder is a major cause of malignant obstructive jaundice in India. It usually presents at an advanced sta ge and endoscopic palliation is the mainstay of treatment. We prospect ively studied our results with endoscopic stenting in patients with ca rcinoma Of the gallbladder. Methods: Patients unfit for surgery were i ncluded in the study. Straight 10F plastic prostheses were placed endo scopically. Patients were assessed for procedure success, early and la te complications, and stent patency. Results: The success rate of sten t placement was 84% (27 of 32). The five failures were caused by an in ability to pass the guide wire across the stricture. Relief of pruriti s and reduction in jaundice was seen in 25 of 27 (92%) patients. Doubl e stents were placed in three patients. Four patients (11%) developed cholangitis in the first 30 days. Stent occlusion was detected in four patients after longer follow-up. The 30-day mortality was 5 of 27 (18 %). There were no procedure-related deaths. Conclusion: Endoscopic end oprosthesis is a safe and relatively effective palliative measure for the majority of patients with unresectable carcinoma of the gallbladde r.