MALIGNANT BILE-DUCT OBSTRUCTION - EXPERIENCE WITH SELF-EXPANDING METAL ENDOPROSTHESES (WALLSTENTS) IN AUSTRIA

Fifty-two patients in nine Austrian hospitals were treated with biliar y self-expanding metal endoprostheses (Wallstents) for malignant bilia ry obstruction, and followed up retrospectively using questionnaires, answered by the endoscopists. Stent placement was successful in all pa tients. The technical failure rate at the first attempt was 7.7%, and stenting-associated mortality was 3.8% due to mispositioning of stents , leading in two cases to death. The 30-day mortality was 13.5%, and e arly complications occurred in 15.4%. The median survival was 216 days , and the median stent patency was 291 days. During follow-up, stent o cclusion was observed in ten patients, acute cholangitis in 12 patient s, acute pancreatitis in three patients, acute cholecystitis in one pa tient, and duodenal ulceration due to stent erosion in one patient. Ro utine use of biliary self-expanding metal endoprostheses by averagely experienced endoscopists can be recommended. Attention has to be paid to the correct placement of the guidewire and stent.