Published online Jan 7, 2006. doi: 10.3748/wjg.v12.i1.119
Revised: June 28, 2005
Accepted: July 1, 2005
Published online: January 7, 2006
AIM: To compare the efficacy of self-expandable metallic stents (EMS) in the treatment of distal and proximal stricture of malignant biliary tumors.
METHODS: From March 1995 to June 2004, 61 patients (40 males, 21 females) with malignant biliary obstruction who received self-expandable metallic stent implantation were reviewed retrospectively. The stents were inserted by an endoscopic or percutaneous transhepatic method. We tried to place two stents in the biliary system in T or Y configuration in cases of hilar tumors with bilateral hepatic duct obstruction. The end points of the study were stent occlusion or patient death.
RESULTS: The mean time of stent patency was 421 ± 67 d in the group of proximal stricture( group I) and 168 ±18 d in the group of distal stricture (group II). The difference was significant in borderline between the two groups (P = 0.0567). The mean survival time was 574 ± 76 d in group I and 182 ± 25 d in group II. There was a significant difference between the two groups (P = 0.0005).
CONCLUSION: EMS implantation is a feasible, palliative method for unresectable malignant biliary obstruction. The clinical efficacy of EMS in patients with proximal hilar tumors is better than that in patients with distal tumors.