A self-expandable metallic stent (EMS) was implanted in the bile duct in 20 patients with inoperable malignant biliary strictures, and was assessed for utility and problems. Anti-tumor therapy was administered to 9 patients. Of 20 patients, 17 patients (85%) returned home after EMS implantation, of whom 7 patients had to return to hospital because of stent obstruction. The 12-month cumulative rate of post-implantation patency was 48.5% and the 12-month cumulative survival rate was 36.4%. There was no difference in patency rate or survival rate in relation to anti-tumor therapy. Complications of EMS implantation occurred in 11 patients (duodenal ulcer in 4 patients, cholangitis in 5 patients, acute cholecystitis in 2 patients and acute pancreatitis in 2 patients) . Internal fistulation by EMS implantation did much to improve the quality of life of patients with inoperable malignant biliary strictures. It shouled be borne in mind, however, complications may occur depending on the site of EMS implantation or the type of EMS.
