MALIGNANT OBSTRUCTION OF THE COMMON BILE-DUCT - LONG-TERM RESULTS OF GIANTURCO-ROSCH METAL STENTS USED AS INITIAL TREATMENT

PURPOSE: To determine how long Gianturco-Rosch metal stents remain pat ent when used as the initial treatment for malignant obstruction of th e common bile duct. MATERIALS AND METHODS: The patency of Gianturco-Ro sch metal stents was prospectively studied in 26 patients with maligna nt obstructive jaundice. Biliary obstruction was caused by pancreatic carcinoma (n = 15), cholangiocarcinoma (n = 10), or metastatic lymphad enopathy (n = 1). Follow-up information was obtained every 3-4 months until death. RESULTS: Stent insertion was successful in all patients. Stent occlusion occurred in nine patients (35%). The overall mean pate ncy period was 39.9 weeks. Adequate biliary drainage for a minimum of 80 weeks or until death was achieved in 19 patients (73%). Life-table analysis predicted stent patency rates of 86%, 75%, and 69% at 12, 24, and 48 weeks, respectively. CONCLUSION: These results are better than those previously reported in patients with plastic endoprostheses. Th e authors believe that insertion of the metal stent is the procedure o f choice in patients with inoperable malignant biliary obstruction.