[Metallic stents in benign biliary stenosis. A four-year follow-up]

From October 1988 to September 1989, 29 self-expanding biliary metallic stents were positioned in 18 patients with recurrent benign biliary strictures, who were no longer candidates to surgical repair and did not respond to percutaneous balloon dilatation. "Z" stent were used in 17 patients and a Wallstent in one case. At four years' follow-up (range: 39-50, average: 46 months), 10 patients remain asymptomatic, without signs of bile stasis (55.5%), five patients had recurrence of symptoms and were subsequently retreated (27.7%) and three patients died from severe underlying diseases, two of them with stent obstruction, one without signs of bile stasis. Recurrences were caused by stent obstruction in three cases. At four years' follow-up the overall patency rate is 68.7%. According to the type of stricture treated, patency is 100% in the group of patients with single CBD stenosis and in the patients with single anastomotic strictures, whereas in all patients with multiple or complicated strictures the stents completely occluded within 4-22 months.