[Endoscopic prosthesis of the biliary tract].

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Oncology

Context:

• Biliary tree obstruction presents significant clinical challenges.
• Malignant strictures and large common bile duct stones necessitate effective management strategies.
• Endoscopic stenting has emerged as a less invasive therapeutic option.

Purpose:

• To evaluate the efficacy and outcomes of endoscopic biliary tree stenting in patients with malignant biliary strictures and common bile duct stones.
• To assess the impact of stenting on serum bilirubin levels and prosthesis patency.
• To compare stenting as an alternative to surgical palliation.

Summary:

• A study involving 64 patients undergoing endoscopic biliary tree stenting between 1987-1989.
• Group I (36 patients) had malignant strictures (ampulla of Vater, pancreatic head, bile duct/bifurcation tumors, gallbladder cancer).
• Group II (28 patients) had common bile duct stones unsuitable for endoscopic removal, with surgery contraindicated.
• Stenting rapidly improved elevated serum bilirubin levels (approx. 50% decrease in 7 days).
• Mean prosthesis patency was 144 days (Group I) and 183 days (Group II).
• Mean survival in Group I was 220 days.

Impact:

• Endoscopic biliary stenting is a valuable alternative to surgical palliative treatment for obstructive neoplastic jaundice.
• It provides an efficient method for managing common bile duct stones in patients with poor operative risk.
• The procedure demonstrates rapid improvement in cholestasis markers and durable patency.