Endoscopic biliary stents and obstructive jaundice

Eighty-four patients with obstructive jaundice due to various causes were treated with endoscopically placed plastic stents. Seventy-two patients had malignant obstructive disease, 5 patients had common bile duct stones, 4 patients had bile duct injuries, and 3 patients had inflammatory processes resulting in common bile duct obstruction. Straight as well as double pigtail stents ranging from 9 to 12 F. were used. Restenting was employed only in patients with malignancy, and the longest period of a single stent drainage was 406 days with the average of 132 days. There was one procedure-related mortality in a patient with pancreatic cancer in whom the stent was misplaced. Inadequate drainage resulted in cholangitis and death. There were 14 nonfatal complications which included 1 myocardial infarction, 2 liver abscesses, 2 early closures (at 8 and 18 days), 1 episode of cholecystitis, 3 displacements of the stent which required restenting, and 4 spontaneous passages of the stent through the gastrointestinal tract. There were no perforations and no significant bleeding was encountered.