PALLIATION OF MALIGNANT OBSTRUCTIVE-JAUNDICE - USE OF SELF-EXPANDABLEMETAL STENTS

Purpose: The aim of this study was to analyze the clinical efficacy of metal stents in the palliation of malignant obstructive jaundice. Mat erial and Methods: Fifty patients with malignant biliary obstruction w ere palliated by means of drainage with a metallic self-expandable ste nt (Wallstent). Nineteen patients had pancreatic carcinoma, 22 cholang iocarcinoma, 4 hepatocellular carcinoma, and the remaining 5 metastati c carcinoma from a variety of primary sites. The obstruction was at th e level of the liver hilum in 19 cases, in the middle common bile duct in 11, and in the lower common bile duct in 20. Results: The patients were followed over a period of 1-17 months. A total of 36 patients (7 2%) died; 14 (28%) survived. The mean observation time for the whole g roup of 50 patients was 3.3 months. The 30-day mortality rate was 14% (7 patients). Shortterm complications occurred in 6 patients (12%). Lo ng-term complications included stent occlusion requiring a 2nd interve ntion in 2 patients (4%), and cholangitis in 2 pa tients (4%). Excelle nt palliation was achieved in most of the patients. No stent migration was observed. Conclusion. The metallic stent provides good palliative drainage, and the percutaneous insertion of metallic stents is well t olerated by the patients. The procedure is simple and safe to use and can be executed in one stage. The one-stage procedure, compared to the 2-stage procedure, may reduce hospital stays.