Document Detail


Malignant biliary obstruction: treatment with self-expandable stainless steel endoprosthesis.
MedLine Citation:
PMID:  1335839     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Metal endoprostheses of the Wallstent type were successfully inserted percutaneously and endoscopically in 80 consecutive patients with malignant obstructive biliary stenoses, who were followed for up to 18 months. The indication for treatment was jaundice due to malignant biliary obstruction. Repeat radiological investigations were performed if the patient had symptoms suggesting stent occlusion. After stent implantation, 88% of patients demonstrated a serum bilirubin decrease by more than 50%. We observed a 15% rate of serious complications, including a 10% rate of cholangitis with septicemia. There were no cases of stent migration or occlusion due to encrustation of bile. Recurrent jaundice occurred in 17.5% of patients due to progressive tumor growth after 3-10 months. In 5 of these patients, tumor overgrowth was redilated and/or restented. Of the 80 patients, 34% are alive after 2-12 months (mean: 242 days); of these, two-thirds are free of jaundice. Sixty-six percent of patients died between 3 days and 1.5 years (mean: 133 days). Although autopsy investigations revealed the possibility of tumor growth onto the inner surface of the stent, through the mesh of the endoprosthesis, no stent occlusion by tumor ingrowth into the lumen occurred. Self-expandable stainless steel endoprostheses provide good palliation in patients with malignant obstructive jaundice.
Authors:
E K Salomonowitz; A Adam; F Antonucci; G Stuckmann; C L Zollikofer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  15     ISSN:  0174-1551     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    1992 Nov-Dec
Date Detail:
Created Date:  1993-02-11     Completed Date:  1993-02-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  351-5     Citation Subset:  IM    
Affiliation:
Department of Radiology, Kantonsspital Winterthur, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adenoma, Bile Duct / complications*
Adult
Aged
Aged, 80 and over
Balloon Dilatation
Bile Duct Neoplasms / complications*
Bilirubin / blood
Cholangiography
Cholestasis, Intrahepatic / etiology*,  therapy*
Constriction, Pathologic / etiology,  therapy
Drainage / instrumentation
Humans
Middle Aged
Prostheses and Implants* / adverse effects
Prosthesis Design
Radiology, Interventional
Stainless Steel*
Stents / adverse effects
Surface Properties
Survival Rate
Chemical
Reg. No./Substance:
12597-68-1/Stainless Steel; 635-65-4/Bilirubin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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