Percutaneously placed Wallstent endoprosthesis in patients with malignant distal biliary obstruction

Seventy-five patients with malignant distal biliary obstruction were treated by percutaneously placed self-expandable Wallstent endoprostheses for palliative drainage. The stent diameter was 1 cm and its length 3.5-10.5 cm. Early complications occurred in 16 patients (21 per cent); they were related to the endoprosthesis in five (7 per cent) and serious in six (8 per cent). The 30-day mortality rate was 15 per cent, with a 1 per cent procedure-related mortality rate. Sixty-five patients died 6-365 (median 87) days after stent insertion and four had recurrence of obstruction after 21-341 (median 152) days. Reobstruction was the result of tumour ingrowth in one patient, angling of the stent in one and an unestablished cause in two. Ten patients were alive without obstruction 31-383 (median 65) days after stent insertion. Percutaneous use of the Wallstent endoprosthesis allows easy insertion; reobstruction is rare.