Malignant obstruction of the common bile duct: long-term results of Gianturco-Rosch metal stents used as initial treatment.

Abstract

To determine how long Gianturco-Rosch metal stents remain patent when used as the initial treatment for malignant obstruction of the common bile duct. The patency of Gianturco-Rosch metal stents was prospectively studied in 26 patients with malignant obstructive jaundice. Biliary obstruction was caused by pancreatic carcinoma (n = 15), cholangiocarcinoma (n = 10), or metastatic lymphadenopathy (n = 1). Follow-up information was obtained every 3-4 months until death. Stent insertion was successful in all patients. Stent occlusion occurred in nine patients (35%). The overall mean patency period was 39.9 weeks. Adequate biliary drainage for a minimum of 80 weeks or until death was achieved in 19 patients (73%). Life-table analysis predicted stent patency rates of 86%, 75%, and 69% at 12, 24, and 48 weeks, respectively. These results are better than those previously reported in patients with plastic endoprostheses. The authors believe that insertion of the metal stent is the procedure of choice in patients with inoperable malignant biliary obstruction.