COVERED GIANTURCO STENTS FOR MALIGNANT BILIARY OBSTRUCTION - PRELIMINARY CLINICAL-EVALUATION

PURPOSE: To evaluate the effectiveness of covered Gianturco stents in patients with malignant biliary obstruction. MATERIALS AND METHODS: Th ree types of partially polyurethane-covered stents were implanted in 1 9 patients with malignant biliary obstruction located distal to the hi lar confluence, A transhepatic approach was employed in all but one pa tient, in whom the stent was placed through a T-tube tract, RESULTS: S tent placement was possible in all patients, In 15 patients, the impla nted stents were expanded to a mean of 81% of their original diameter, In the remaining four patients, the stents expanded to less than 40% of the original diameter, and balloon dilation and additional bare ste nt placement were required, All patients except one, who had impairmen t of liver function due to multiple liver metastases, showed relief of jaundice after stent placement, At follow-up, which ranged from 5 to 57 weeks (mean, 24.7 weeks), one stent (5%) was occluded after 26 week s due to tumor growth above the upper stent edge, and required seconda ry intervention, Complications in three patients included stent migrat ion in one (5%) and cholangitis in two (11%). CONCLUSION: Preliminary results suggest that placement of covered Gianturco stents is feasible , the complication rate is acceptable, and short-term patency appears promising.