[Palliative endoscopic treatment of malignant occlusive jaundice with a balloon expandable metal stent]

Balloon-expandable Strecker-stents were endoscopically inserted in 13 patients (8 females, 5 men; mean age 75.2 [55-99] years) suffering from malignant obstructive jaundice. The stent implantation was difficult in one patient because of trouble to retract the balloon carrying the stent. A prompt regression of the cholestasis resulted in 11 patients. Two patients with long-distance stenoses of the common hepatic duct showed a persistent icterus due to an incomplete drainage of the stenoses. Therefore a second stent was implanted by means of transhepatic procedure in one case. Additional early complications such as cholangitis did not occur within four weeks after insertion. During the follow-up of four up to 41 weeks (mean follow-up 15.2 weeks) we observed late complications in five patients: stent migration in one patient after 10 weeks; relapsed jaundice in four patients 11 up to 41 weeks after stent implantation (the reason of jaundice was unknown for these patients were not again sent to our hospital because of their bad conditions). Six patients were alive without evidence of icterus on the date of examination. Considering data from the literature Strecker-stent implantations have been rarely performed in biliary duct stenosis till now. But the results demonstrate that an effective drainage of bile duct stenoses can be achieved in a high percentage by means of balloon-expandable metal stents. The insertion of the stent can be rather easily performed in stenoses situated in Vater's papilla and common bile duct provided that the guide wire has passed the stenosis.