[Biliary endoprosthesis of malignant biliary obstruction using expandable metallic stent--preliminary clinical...

Thirty-eight patients with malignant biliary obstruction were treated with expandable metallic stent (EMS). Successful insertion of stents was attained in all cases, and in 34 of 38 patients, the stents remained patent and sufficiently expanded, and led to the removal of external drainage catheter. No serious complications occurred. In two cases, stents were deformed in shape, associated with no side effects. In follow-up, eleven patients developed recurrent jaundice due to tumor ingrowth between the wires and the tumor grew up along the initially placed stents. In six patients, additional stents were installed inside the initially placed stents, in whom the additional stents were placed successfully and remained patent thereafter. The expandable metallic stents were superior to the conventional tube stents, but there were some problems in our limited experience: stents deformity, slipping migration, fracture of stents and rapid obstruction. Further investigation is under way to resolve these problems. Long-term trials are required before established routine use of EMS. The expandable metallic stent was, however, expected to offer a new alternative in the management of malignant biliary obstructions and to afford long-term patency of affected biliary tracts.