Benign bile-duct stenoses - treatment with self-expanding metallic stents or silicon prostheses (Yamakava) in inoperable stenoses or high operative risk cases

Introduction: High benign biliary stenoses, which can occur as a complicati on of disease or surgery, may be difficult to correct by open surgery and m ay also carry a high risk. An alternative to surgery is the percutaneous im plantation of a flexible metallic stent or silicon prosthesis at the affect ed site. Methods: Twelve patients with benign biliary stenoses have been op erated on in our department since March 1992, and the therapeutic success w as reviewed in this study. Results: Six received a Palmaz stent and six a s ilicon prosthesis, with a follow-up after completion of treatment of more t han 7 years and more than 3 years, respectively. Fifty percent of the patie nts with a stent experienced no problems and 66 % of the stents remained pa tent (including one requiring operative intervention to restore patency). N o further surgery was necessary in any of the patients with a silicon prost hesis. Conclusion: When the advantages and disadvantages of the various pro cedures are considered, long-term splinting with a wide-lumened silicon pro sthesis (Yamakava) appears to be a promising alternative to surgery for the treatment of benign biliary stenosis.