Summary
The main problem with palliative treatment of extrahepatic cholestasis with an endoscopic
biliary endoprosthesis is clogging. One of the factors thought to be of importance
is the diameter of the stent. In order to avoid being limited by the size of the instrumentation
channel of the endoscope, expandable stents have been developed. In this article we
report on our preliminary clinical experience with an endoscopically placed expandable
metal stent (“Wallstent”) in 33 patients with extrahepatic bile duct stenoses. When
fully expanded, the stent has a diameter of 30 F and a length of 6.7 cm. It was possible
to successfully place a stent in every patient. Clinical improvement was achieved
in all patients except one. Two patients underwent elective surgery, while one died
of renal failure. Another died of septic shock after 5 weeks, but no autopsy was performed.
In conclusion, our initial experience with this stent shows that at least in the short
term biliary drainage was excellent, with no complications of pancreatitis or hemorrhage.
Longer follow-up than our 4 weeks is necessary to establish the position of this stent
in comparison with the conventional endoprosthesis in the management of obstructive
jaundice.
Key words:
Biliary stricture - New stent - Biliary drainage
