In this study, researchers from Turkey evaluated 154 patients with inoperable malignant biliary obstruction, who underwent percutaneous placement of metallic stents.
During a 6-year period, the researchers inserted 224 self-expanding metallic stents in 154 patients with inoperable malignant biliary obstruction.
|Success rate within the first 30 days was 88%.|
Of these patients, 100 had obstructions at the proximal (supracystic) level, and 54 at the distal (infracystic) level.
The team identified causes of obstructions as hilar cholangiocarcinoma (n = 64), pancreatic carcinoma (n = 34), gallbladder carcinoma (n = 24), metastatic carcinoma (n = 21), common bile duct carcinoma (n = 8), and hepatocellular carcinoma (n = 3).
A complete follow-up was available for all patients.
The researchers found that the 30-day mortality was 9%, with no procedure-related deaths.
Furthermore, the clinical success rate within the first 30 days was 88%.
The team determined that the rate of early, procedure-related complications was 28%. Half of these complications were due to the percutaneous transhepatic catheter drainage procedure.
Recurrent jaundice occurred in 18% of patients. In 82% of these, the team performed reintervention in order to relieve the reobstructions.
The researchers found that the mean length of survival for all patients was 4 months, while the mean period of patency for stents was 6 months.
They found no significant difference in patient survival or stent patency periods with regard to the level and cause of obstruction.
Dr Inal’s team concluded, “Percutaneous metallic stent placement maintains equal palliation in patients with proximal and distal malignant biliary obstructions caused by any tumor type”.
“Most of the early complications were due to procedures performed before stent insertion and could be decreased by direct stent insertions.”
“The most common late complication, reobstruction, is inevitable but can be easily treated in the majority of patients.”