Clinical evaluation of endoscopic stents placement for biliary tract diseases

[Objective] To evaluate the technique of placement of mental stent and plastic stent for palliation of malignant and benign biliary obstruction. [Methods] The biliary obstruction of all the cases was diagnosed through ERCP, and under fluoroscopic guidance the stent was inserted into the right site from oral cavity. The patients with plastic stents included 30 cases, and those with mental stents included 26 cases. Jaundice index, liver function and complications were investigated during the study period of 3～6 months. [Results] Successful stent placement was achieved in all the cases. 7 days after operation, in plastic stent cases, Blood serum total bilirubin(STB), glutamicpyruvic transaminase (ALT), r-glutamyl transpeptidase (r-GT) and alkaline phosphatase (ALP) decreased 51.25%, 52.09%, 29.07% and 36.18%, respectively. In mental stent cases, STB, ALT, r-GT and ALP decreased 70.25%, 55.23%, 41.68% and 43.74%, respectively. The early complications included ERCP associated pancreatitis (2 cases, 3.57%) and cholangitis (3 cases, 5.34%), and obstruction of stent (3 cases, 5.34%) was the major late complication. [Conclusion] The endoscopic stent placement is a safe and efficient method for malignant and benign biliary obstruction, and it can improve patient's living quality. Plastic stent is an efficient therapy for all the benign biliary obstructions and malignant obstruction of patients with life expectancy no more than 3 months. Mental stent is the best choice for patients with malignant obstruction who have lost the capability of surgery.