BENIGN BILIARY OBSTRUCTION - IS TREATMENT WITH THE WALLSTENT ADVISABLE

PURPOSE: To evaluate the effectiveness of the self-expanding Wallstent in the treatment of benign biliary strictures. MATERIALS AND METHODS: Twenty patients with benign biliary strictures were included in this retrospective study. Seven patients had chronic pancreatitis, two had fibrous papillary stenosis, one had primary sclerosing cholangitis, an d 10 had postsurgical strictures, including four who had a stenosed bi lidigestive anastomosis. Primary and secondary patency of the stents a nd clinical outcome after stent insertion were evaluated. RESULTS: Ste nt placement was successful in all patients. At the end of the observa tion period, which lasted 3-78 months (mean, 31.2 months +/- 4.5 [stan dard error]), 10 patients were alive. Median primary patency was 32 mo nths +/- 8.7. In 10 patients, patency was preserved during the observa tion period (two with secondary patency). Six patients had a good clin ical result. Among the other four patients, one had recurrent cholangi tis, one had a biliary abscess, and two had stent revisions. In the ot her patients, stents became occluded after 3-55 months. The reason for stent occlusion was a stone in one patient; in the others, the causes were not proved. CONCLUSION: Results of stent placement for treatment of benign biliary strictures are not encouraging. However, the patien t population is too limited to allow final conclusions.