[Endoscopically inserted plastic endoprosthesis in the palliative treatment of malignant obstructive jaundice]

Experience is reported of palliative treatment for malignant obstructive jaundice by plastic drain positioned in the biliary tract during endoscopic retrograde cholangiopancreatography (ERCP). In the period January 1989 to December 1991, 35 plastic drains (10-12 French) were implanted in 22 patients of mean age 70 (range 51-88) years because of obstruction due to biliary tract carcinoma (n = 10), metastases (n = 5), pancreatic carcinoma (n = 4) and papillary carcinoma (n = 3). Endoscopic positioning was successful in 86% of cases. The early complication rate was 4.5% (cholangitis) and the 30-day mortality 14%. In 89% of cases drainage was effective and the obstructive jaundice subsided within 3 months. Late complications occurred in 36% of patients, involving cholangitis due to drain obstruction (n = 5) and drain displacement (n = 2). In 27% of patients the drain had to be changed 1-3 times, on the first occasion after an average of 146 (range 14-421) days. The patients' median survival was 5 months.