ENDOSCOPIC STENTING IN THE MANAGEMENT OF MALIGNANT BILIARY OBSTRUCTION

A relevant percentage of patients with malignant biliary obstruction a re not candidates for surgery when the diagnosis is made. Endoscopical ly placed biliary stents have shown their efficacy in the palliative m anagement of these patients although they do not seem to increase thei r survival. We report on a retrospective analysis of 37 patients with malignant biliary obstruction treated with endoscopic biliary stents. The distal third (62%) of the main life duct was the most frequent com mon location for the obstruction, and pancreatic cancer was the most f requent cause of obstruction (64%). Twenty three plastic (13-7F and 10 -10F) and 14 metallic stents were placed initially. Forty four percent of the plastic stents (all of them 7F, none 10F) were removed after 3 9 days against 30% of the metallic stents after a mean period of 60 da ys. Global survival was 153 days (110 in the plastic stents' group ver sus 195 in the metallic one, p: NS). We could only make a complete fol low up in 52% of the patients. Conclusions: endoprotheses are a good p alliative treatment for malignant biliary obstruction. When plastic st ents are used they should have a wide calibre (10F or greater). Metall ic stents result in an increase of survival time without statistical s ignificance.