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Complications of percutaneously inserted biliary Wallstents
1Department of Radiology, University Hospital Dijkzigt, Erasmus University Rotterdam, The Netherlands.
Journal of Vascular and Interventional Radiology : JVIR
|November 1, 1993
Summary
Percutaneous Wallstent endoprosthesis insertion for malignant biliary obstruction shows manageable early complications. Reobstruction, primarily due to tumor progression, is the main late complication, favoring Wallstent over plastic stents.
Area of Science:
- Interventional Gastroenterology
- Oncology
- Biliary Interventions
Background:
- Malignant biliary obstruction poses significant challenges in patient management.
- Percutaneous endoprosthesis insertion is a key intervention for palliation.
Purpose of the Study:
- To assess complications associated with percutaneous Wallstent endoprosthesis insertion.
- To evaluate the efficacy of Wallstents in patients with inoperable malignant biliary obstruction.
Main Methods:
- A total of 207 Wallstents were implanted in 176 patients with malignant biliary obstruction.
- Patients presented with either hilar (74) or distal (102) strictures.
- Median survival post-stent placement was 95 days.
Main Results:
- Early complications (7%) included cholangitis and reobstruction; 30-day mortality was 12%.
- Late complications (20%) were predominantly reobstruction (19%), with tumor overgrowth being the primary cause.
- Reintervention benefited 19 out of 25 patients.
Conclusions:
- Wallstent use is preferred over plastic stents for malignant biliary obstruction.
- The main complication, reobstruction, is largely attributed to tumor progression rather than stent failure.