Abstract
Biliary metallic stems are thought to offer improved long-term palliation of malignantbiliary strictures. We experienced 32 patients with unresectable malignant biliary stricturetreated with a metallic stmt. Seventeen Strecker stentsTM, 14 WallstentsTM and one ZstentTM were applied, and were implanted via an endoscopic route in 22 patients andtranshepatic route in 10 patients. Their long-term results were evaluated in comparisonwith those of cases of ERBD (105 patients)and cases of surgical operation (23 patients withadvanced pancreatic cancer). The scents were successfully implanted in all patientswithout any complications. Stent clogging occurred in g of 32(28%)patients. One patientdied of massive bleeding due to cholangio-duodenal fistula formation about 3 months afterplacement of a metallic stent. Eighteen patients(56%)died within a mean of 162 days and4(16%)are still alive for a mean of 168 days without stent clogging. The stent patency ofrnetallic stent, a mean of 157 days in 21 patients, was significantly longer than that ofplastic stent, a mean of 68 days in 23 patients. There was no significant difference insurvival rates arnong two surgical procedures(pancreato-duodenectomy:n=12, bypassoperation:n=11)and metallic stenting(n=11)in advanced pancreatic cancer.
