BILIARY STRICTURES IN LIVER-TRANSPLANT RECIPIENTS - TREATMENT WITH METAL STENTS

PURPOSE: To determine initial and long-term results of metal stent pla cement in biliary strictures that failed to respond to balloon dilatio n. MATERIALS AND METHODS: Sixty-one metal stents were placed in 36 liv er transplant recipients (age range, 3 months to 71 years) with biliar y strictures that failed to respond to balloon dilation. Patients were followed up for up to 5 years. RESULTS: Initial stent placement was s uccessful in all patients. Primary patency was 44% at 3 years and was 0% at 5 years; secondary patency was maintained at 88% at those interv als. Patency associated with the Gianturco Z stent was superior to tha t with the Palmaz stent. Stents located at anastomotic sites had highe r patency rates than those at nonanastomotic sites. Major stent-relate d complications occurred in eight patients and included two pediatric deaths. CONCLUSION: Metal stents can be useful in the short term but h ave limited patency, often require repeat intervention, and have subst antial complications. Long-term success depends heavily on repeat inte rventions or stent removal.