Percutaneous transhepatic placement of expandable metallic stents in biliary obstruction

Treatment of choice for obstructive jaundice of different origin is the per cutaneous transhepatic placement of endoprostheses if the endoscopic access fails for technical or anatomical reasons. Expandable metallic stents are generally preferred to plastic endoprostheses because of higher patency rat es. Purpose of this study was to retrospectively evaluate the clinical effi ciency and the occlusion rates of percutaneous placed metallic stents in 39 patients with malignant and benign biliary obstruction and to compare the results to a review of the literature. Placement of the stents was successf ul in all cases. Patients were followed-up for a mean period of seven month s (1-38 months). 35% were treated with a second procedure. Since the occlus ion rates of percutaneous transhepatic metallic stents increase after six m onths and follow-up in most studies is short the real occlusion rates must be expected to be higher than reported. Therefore and in view to the high c osts indication for the use of metal stents in biliary obstruction should b e carefully checked.