[Endoscopic drainage of the bile ducts]

Insertion of biliary endoprosthesis was attempted in 151 patients with obstructive jaundice and was successful in 124 patients (82%). The indications for the procedure were: 1) biliary and pancreatic neoplasms (79 patients) and 2) non-neoplastic diseases such as common bile duct stones or postoperative biliary strictures (45 patients). Successful drainage of bile was obtained in 95% of patients from the first group and in 93% of those from the second group. The mean survival time of patients with neoplasms was 4.5 months and the majority of them were free of jaundice and itching. In 32 patients with non-neoplastic diseases there was no recurrence of jaundice after a mean time of 20 months. Serious complications occurred in 5 patients (4%), 4 of them died (3.2%). The most frequent late complication was clogging of the endoprosthesis (19% of patients from the first group after a mean time of 5 months and in 28% of those from the second group after a mean time of 16 months). Replacement of the endoprosthesis was carried out mainly on the ambulatory basis. Endoscopic biliary stenting is an effective method of palliative biliary drainage in patients with non-operable biliary and pancreatic tumours. In high risk patients with non-neoplastic obstructive jaundice the technique may be an alternative for surgical treatment.