TRUE SINGLE-STAGE PERCUTANEOUS INSERTION OF WALLSTENT BILIARY ENDOPROSTHESES

It is standard practice to leave a temporary external catheter in plac e for 24-48 h after biliary Wallstent placement. We aimed to establish the safety and effectiveness of a true single-stage procedure. Twenty -two patients underwent Wallstent insertion for palliation of malignan t obstruction of the biliary tract. Following percutaneous cholangiogr aphy and balloon dilatation of the stricture, 10 mm Wallstent endopros theses were inserted extending from the upper common hepatic duct to t he duodenum. The introducer was then exchanged for a catheter and a ch olangiogram performed. In 11 cases the catheter was removed, in the re maining cases it was not removed until after a satisfactory cholangiog ram at 24-48 h. All of the patients from whom the catheter was removed made a good recovery with no procedure-related complications; in part icular no early stent obstruction or leakage of bile was observed. Rig ht flank pain was minimized and mobilization accelerated by the absenc e of an external catheter. We feel that true single-stage percutaneous introduction of Wallstent biliary endoprostheses is safe and effectiv e in patients with lesions in the common bile duct.