Summary:
The authors submit the results of a study of 67 patients with malignant obstructions of the biliary
tract who were treated, using 83 metallic self-expanding Ella stents, covered and uncovered variety
- in the course of 39 months from August 1994 till October 1997.
In 25 patients uncovered stents were used, in another 25 stents lined with a polyurethane membrane.
In 8 patients the authors first placed an uncovered stent in the right bile duct and subsequently
a covered stent in the left bile duct. In 9 patients a metallic expanding stent was combined with
brachytherapy with iridium (Ir) 192.
The technical success of the use of stents was 96.5%. No immediate serious complications associated
with insertion of the stent occurred. The thirty-day mortality was 16% regardless whether covered
or uncovered stents were used. The mean period of patency of the stents was 153 days in covered
stents and 144 in uncovered stents. When evaluating the interval between insertion of the stent and
the patient’s death no significant difference was observed between covered and uncovered stents -
157 and 161 days resp. When the stent was combined with brachytherapy with Ir 192 a significantly
longer survival period was achieved - 277 days.
Occlusion of the stent occurred in 9 patients (13.4%). In five instances an uncovered stent was
involved, in two a covered one. In one instance the occlusion occurred in a patient who had both
types of stents.
Key words:
malignant stenosis - metallic self-expanding stent - plastic endoprosthesis - brachythe-
rapy with Ir 192 - interventions on the biliary tract
|