1995 Volume 37 Issue 10 Pages 2185-2192_1
Clinical evaluation of covered Strecker-stent(21 Fr.)specially made by using a silicone rubber(BiobraneR)is presented in the management of inoperable malignant biliary obstruc-tion in comparison with that of uncovered standard Strecker-stent (21 Fr.)and standard plastic stents(10 or 12 Frr.). Endoscopic retrograde biliary drainage(ERBD)was attempted in 82 patients with inoperable biliary or pancreatic malignancies;54 patients with pancreatic cancer, 13 with common bile duct cancer, 11 with gallbladder cancer, one with ampullary cancer and three with metastasis of gastric cancer. All patients had only an Obstruction of the extrahepatic bile duct excluding the hilar portion and had neither adjuvant chemotherapy nor radiation.In this series, standard plastic stents were used in 60 patients, uncovered standard Strecker-stent was applied in seven patients and specially designed covered Strecker-stent was employed in 15 patients. The obstruction rate of the uncovered Strecker-stent and plastic stent were 57% and 77%, and the mean patency of these stents taken by Kaplan-Meier's method was 99 days and 102 days respectively. The uncovered Strecker-stent was not able to provide the significant long-term patency compared to the conventional plastic stems due to the early obstruction caused by tumor ingrowth through its metallic mesh. On the other hand, the obstruction rate of the covered Strecker-stent was decreased in 40/and its mean patency term enlarged to 272 days because of preventing tu-mor ingrowth. These results suggest that the covered Strecker-stent has the superiority over the uncovered Strecker-stent and 10 Fr. or 12 Fr. plastic stent in the relief of malignant biliary stricture of the bile duct.
