Endoscopic placement of biliary stent in treatment of malignant biliary obstruction

Objective To evaluate the efficacy of endoscopic placement of biliary stent in treatment of malignant biliary obstruction.Methods A total of 176 patients with maligmant biliary obstruction,who had lost the chance for surgery,were treated with biliary stent through endoscopic retrograde cholangiopancreatography.Seventy patients received endoscopic retrograde biliary drainage with single stent,52 patients with double stents,and 54 patients with endoscopic metal biliary endoprothesis.The drainage outcomes and the early complications were compared between different groups.Results The levels of alkaline phosphatase(ALT),total bilirubin(TB),direct bilirubin(DB) and alkaline phosphatase(AKP) in the three groups were significantly decreased after operation compared with before operation(P0.05).The post-stenting levels of TB and DB of in double stent and metal stent groups were significantly lower than those of the single stent group(P0.05),but with no significant difference found between the former two groups(P0.05).The successful rate of single stent group(97.1%) was significantly higher than that of the double stent group(78.8%,P0.05),but they were not significantly different from that of the metal stent group(92.6%)(P0.05).The incidences of early complications of the single stent(15.7%) and double stent(13.5%) groups were significantly higher than that of metal stent(1.9%) group,but with no significant difference found between the former two(P0.05).Conclusion Endoscopic stenting is effective in treatment of malignant biliary obstruction,and the efficacies of endoscopic retrograde biliary drainage with double stent and metal biliary endoprothesis are better than that with single stent.