Patency and complications of percutaneously inserted metallic stents in malignant biliary obstruction

PURPOSE: The aim of this study was to analyze the: patency of percutaneousl y inserted metallic stents in malignant biliary obstruction and to evaluate all the complications associated with the stents and the reinterventions n eeded. MATERIALS AND METHODS: Thirty-nine patients with 42 malignant strictures we re treated percutaneously with 55 metallic self-expandable stents, Forty-ei ght were Wallstents and seven were Memotherm stents, Twenty-five strictures were hilar, 16 were in the common bile duct, and one was in the hepaticoje junal anastomosis. The patients were followed until death and the mean foll ow-up was 6.4 months. RESULTS: Stent insertion was successful in 97% of the patients. Thirty perc ent had early complications (<30 days), and as many as 66% had late complic ations, including stent occlusions, which were seen in 10 patients. The pat ency rates of patients with cholangiocarcinoma were significantly lower tha n those of the patients with other diagnoses,There was also a tendency towa rd obstruction with less dilation of the stents, Y, T or tandem-style stent placement, an increasing number of stents, longer strictures, and hilar st rictures. Thirty-one percent of the patients alive after the first 30 days had late reinterventions. CONCLUSIONS: Although metallic stents offer an alternative in the palliatio n of malignant bile duct obstruction, there seem to be numerous early and l ate complications.