Malignant Bile-Duct Obstruction: Experience with Self-Expanding Metal Endoprostheses (Wallstents) in Austria

R. Schöfl; E. Brownstone; W. Reichel; W. Fortunat; F. Doblhofer; H. J. Samec; G. Brandstätter; T. Stupnicki; H. Pamperl; P. Schreiber; A. Gangl

doi:10.1055/s-2007-1009045

Endoscopy 1994; 26(7): 592-596
DOI: 10.1055/s-2007-1009045

Malignant Bile-Duct Obstruction: Experience with Self-Expanding Metal Endoprostheses (Wallstents) in Austria

R. Schöfl¹ , E. Brownstone² , W. Reichel³ , W. Fortunat⁴ , F. Doblhofer⁵ , H. J. Samec⁶ , G. Brandstätter⁷ , T. Stupnicki⁸ , H. Pamperl⁹ , P. Schreiber¹⁰ , A. Gangl¹

¹Department of Clinical Gastroenterology and Hepatology, University Clinic for Internal Medicine IV, Vienna
²Department of Medicine IV, Krankenanstalt Rudolfstiftung, Vienna
³Department of Medicine IV, Wilhelminenspital, Vienna
⁴Department of Medicine II, Landeskrankenhaus, Klagenfurt
⁵Department of Internal Medicine I, Krankenhaus Wels
⁶Department of Internal Medicine, Krankenhaus St. Veit a.d. Glan
⁷Department of Medicine II, Landeskrankenhaus Graz
⁸Landeskrankenhaus Deutschlandsberg
⁹Krankenhaus St. Elisabeth, Vienna
¹⁰Institute of Medical Statistics, University of Vienna, Austria

Abstract

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Abstract

Fifty-two patients in nine Austrian hospitals were treated with biliary self-expanding metal endoprostheses (Wallstents) for malignant biliary obstruction, and followed up retrospectively using questionnaires, answered by the endoscopists. Stent placement was successful in all patients. The technical failure rate at the first attempt was 7.7 %, and stenting-associated mortality was 3.8 % due to mispositioning of stents, leading in two cases to death. The 30-day mortality was 13.5 %, and early complications occurred in 15.4 %. The median survival was 216 days, and the median stent patency was 291 days. During follow-up, stent occlusion was observed in ten patients, acute cholangitis in 12 patients, acute pancreatitis in three patients, acute cholecystitis in one patient, and duodenal ulceration due to stent erosion in one patient. Routine use of biliary self-expanding metal endoprostheses by averagely experienced endoscopists can be recommended. Attention has to be paid to the correct placement of the guidewire and stent.

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