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Updated: Aug 13, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Self-expandable metallic stents for malignant biliary obstruction: efficacy on proximal and distal tumors
Jui-Hao Chen1, Cheuk-Kay Sun, Chao-Sheng Liao
1Department of Gastroenterology, Shin-Kong Wu-Ho-Su Memorial Hospital, 95 Weng Chang Road, Shih-Lin District, Taipei, Taiwan,China. m000723@ms.skh.org.tw
Aim:
To compare the efficacy of self-expandable metallic stents (EMS) in the treatment of distal and proximal stricture of malignant biliary tumors.
Methods:
From March 1995 to June 2004, 61 patients (40 males, 21 females) with malignant biliary obstruction who received self-expandable metallic stent implantation were reviewed retrospectively. The stents were inserted by an endoscopic or percutaneous transhepatic method. We tried to place two stents in the biliary system in T or Y configuration in cases of hilar tumors with bilateral hepatic duct obstruction. The end points of the study were stent occlusion or patient death.
Results:
The mean time of stent patency was 421 +/- 67 d in the group of proximal stricture (group I) and 168 +/- 18 d in the group of distal stricture (group II). The difference was significant in borderline between the two groups (P = 0.0567). The mean survival time was 574 +/- 76 d in group I and 182 +/- 25 d in group II. There was a significant difference between the two groups (P = 0.0005).
Conclusion:
EMS implantation is a feasible, palliative method for unresectable malignant biliary obstruction. The clinical efficacy of EMS in patients with proximal hilar tumors is better than that in patients with distal tumors.