[Percutaneous transhepatic metal stents in therapy of bile duct stenoses]

Treatment of choice for obstructive jaundice of different origin is the percutaneous transhepatic placement of endoprostheses if the endoscopic access fails for technical or anatomical reasons. Expandable metallic stents are generally preferred to plastic endoprostheses because of higher patency rates. Purpose of this study was to retrospectively evaluate the clinical efficiency and the occlusion rates of percutaneous placed metallic stents in 39 patients with malignant and benign biliary obstruction and to compare the results to a review of the literature. Placement of the stents was successful in all cases. Patients were followed-up for a mean of seven months (1-42 months). 54% of the patients had recurrent jaundice after a mean period of seven months (1-38 months). 35% were treated with a second procedure. Since the occlusion rates of percutaneous transhepatic metallic stents increase after six months and follow-up in most studies is short the real occlusion rates must be expected to be higher than reported. Therefore and in view to the high costs indication for the use of metal stents in biliary obstruction should be carefully checked.