272 cases of distal malignant biliary obstruction palliatively treated in endoscopic metal biliary stent

[Objective] To explore the therapeutic effect and clinic value of distal malignant biliary obstruction in endoscopic metal biliary stent.[Method] The clinical data of 272 cases of distal malignant biliary obstruction unresectable were retrospectively analyzed.The patients were treated in endoscopic metal biliary stent from December of 2000 to December of 2009.[Result] Endoscopic retrograde cholangio pancreatography were successfully performed in 258 cases (258/272,94.8%).The levels of TBIL and DBIL were restored (73.3%) after stents were implanted two weeks later.Complications were cured including acute cholangititis in 13 patients (5.0%) and hyperamylasemia in 10 patients (3.9%).Follow-up observation was of 182 cases.Average survivng time was (24 ± 3.3) months (range:3～37 months) after endoscopic metal biliary stent treatment.1 year survival was 51.4% (94/182) and 2 year survival was 2.1% (40/182).[Conclusion] Metal stent implantation is safe and effective to relive obstruction for inoperable patients of malignant biliary obstruction with fewer invasive,fewer complication,better improvement of hepatic function and accord with physiology.