ENDOSCOPIC TREATMENT IN PATIENTS WITH JAU NDICE CAUSED BY LIVER METASTASES

The results of endoscopic drainage treatment in 69 patients with metas tases of the liver have been analyzed for the period from 1982 to 1992 . Fifty-five patients had follow-up. Criteria for inclusion were: posi tive diagnosis of liver metastases, jaundice, and primary origin of tu mors distant from the pancreaticobiliary system (''distant'' primary). Localisations of metastic obstructions were: hilum of the liver (n=24 ), commonbile duct (n=16), and prepapillary region (n=15). Treatment w as performed by transpapillary applications of one or more (n=3) pig-t ail or Tannenbaum stents.Concentrations of mean serum bilirubin could be reduced from 14.5 % to 8.8 mg%, 16 patients reached a normal level (less than 1.0 mg%). The median survival time was 76 days ranging vom 4 to 299 days. The most frequent complication was cholangitis in 29 % of the cases with mortality in 6 patients. Patients less than 60 gears of age and with obstructions in the mid commonbile duct gained most b y this kind of treatment. Results mere poor in elderly patients with h ilar stenosis. Selected patients with known liver metastases may benef it from endoscopic treatment of jaundice.