PERCUTANEOUS METALLIC SELF-EXPANDABLE ENDOPROSTHESES IN BILIARY OBSTRUCTION CAUSED BY METASTATIC CANCER

Background/Aims: Up to now, all reports about metallic stents concerne d mostly patients with obstructive jaundice due to primary cancer alth ough some of these series included a smalt number of patients with met astatic disease as a cause of occlusion of the bile ducts. The questio n of whether they should be used in patients with biliary obstruction due to metastatic disease, and consequently have a limited life expect ancy, is investigated. Patients And Methods; Between January 1994 and April 1995, we inserted percutaneously 20 metallic self-expandable end oprostheses in. 14 patients with obstructive jaundice due to metastati c disease. Results: Twelve patients died with a mean survival of 144.6 (range 25 - 338) days without arty evidence of biliary reobstruction. For 2 patients, we have follow-up no Longer than. 30 days. Thirty day mortality was 7.2% (1/14). Jaundice reoccurred in one patient but was n't related to stent obstruction, and he died during the first 30 days . We had 2 cases with moderate hemobilia. Conclusion: We believe that the use of metal stents in patients with obstructive jaundice due to m etastatic disease is justified. Their high initial cost is offset by t heir prolong patency, decreased complication, rate and shorter hospita lization.