Abstract
Endoscopic placement of a self-expandable metallic stent (SEMS) is a widely accepted palliative therapy in patients with an unresectable malignant biliary stricture. The axial force of the SEMS is considered to be one of the causes of complications associated with stent placement. Recently, a new covered biliary stent (WallFlex Biliary RX Stent) having a lower axial force has become commercially available. We evaluated the efficacy and safety of this new covered biliary stent in 21 patients (mean age, 77 ± 12 yrs ; 11 males, 10 females). Twelve patients had pancreatic cancer, 7 had bile duct cancer, and 2 had lymph node metastases. Stents were placed transpapillary in 19 patients. The remaining 2 patients underwent transgastric or transduodenal stent placement utilizing the endosonography-guided biliary drainage route. In the former 19 cases (mean follow-up duration, 102 days), stent placement was successful and improvement of jaundice was obtained in all patients. Early complications and late complications occurred in 21% (3 pancreatitis, 1 cholecystitis) and 16% (2 cholecystitis, 2 migration, 1 bleeding, 1 occlusion) of the cases, respectively. During follow-up, stent occlusion was observed in 5.3%. The remaining 2 patients achieved alleviation of their jaundice. Early and late complications did not occur during follow-up (follow-up duration, 124 days and 327 days).
