Clinical application of stent insertion in bile duct for malignant hilar biliary obstructive jaundice

Objective To determine the therapeutic effect and clinical value of the stent insertion in biliary tract for treatment of malignant hilar biliary obstructive jaundice (MHBOJ). Methods A total of 42 patients with MHBOJ were treated by complete internal and external drainage of biliary tract via unilateral or bilateral hepatic duct puncture and stent insertion. Of the 42 patients, 19 received the single stent insertion in the common hepatic duct, 11 received stent insertion in both left and right hepatic bile duct via bilateral hepatic duct puncture and 12 received stent insertion between the left and right hepatic duct and between the hepatic duct and the common bile duct. Sixty-five stents including 3 coated stents and 62 self-expanding bare ones were used. Results The achievement ratio of operation was 100% in the 42 patients. Two patients suffered from obstruction in the stent in 4 and 9 months, respectively, after the operation and they received the second interventional therapy. One patient suffered from duodenal ileus in 17 months after stent insertion in the bile duct. Therefore, the stent insertion in the dodecadactylon was applied. One patient died of serious infection of biliary tree during the ambi-operation. The follow-up for 3-112 weeks (mean = 49 weeks) in all the patients showed satisfactory results. Conclusions Multiple stent insertion in the bile duct based on different location of obstruction is a safe and reliable palliative therapy with exact therapeutic effect for treatment of MHBOJ.