A 5-YEAR FOLLOW-UP OF SELF-EXPANDING METAL STENTS IN THE ENDOSCOPIC MANAGEMENT OF PATIENTS WITH BENIGN BILE-DUCT STRICTURES

Background Metal stents offer superior biliary drainage in patients wi th malignant bile duct obstruction, with fewer episodes of stent occlu sion compared with polyethylene stents. Metal stent patency has only b een studied over limited time periods in such patients with malignant disease. Objective To assess the long-term patency of metal stents in a group of patients with benign bile duct strictures who are suitable for extended follow-up. Methods Between May 1989 and May 1992, eight p atients (median age 59.0 years; range 26-88 years) with benign biliary strictures were selected at a tertiary referral centre for insertion of a metal stent. Strictures were secondary to bile duct trauma (n = 5 ), chronic pancreatitis (n = 2) or idiopathic (n = 1). A long metal st ent was inserted in three patients and a short metal stent in five pat ients. Results After a median follow-up of 64.5 months (range 26-81 mo nths, seven of the eight patients are alive. Baby scope examination at 1 year showed complete epithelialization of the metal stent in all su bjects examined. Median stent patency was 35 months (range 7-72 months ). Symptomatic episodes of metal stent occlusion have occurred on nine occasions in five patients (62.5%) secondary to mucosal hypertrophy ( n = 3) or biliary calculi (n = 2). Conclusion The long-term management of selected patients with benign bile duct strictures may be signific antly improved by the use of metal stents avoiding the need for freque nt polyethylene stent changes. (C) 1998 Rapid Science Ltd.