Biliary stenting technique in 5 years: a follow-up report of 213 cases

Objective To determine the value of biliary stents in treatment of malignant obstruction of the bile duct, illustrate the technical innovation in the past 5 years and study the therapeutic significance of it used in combination with anti cancer treatments. Methods Percutaneous transhepatic cholangiography and stent insertion were performed in 213 patients with malignant biliary obstruction. Anti cancer treatments were adopted for 104 out of the 213 patients. Results Single stent was inserted in 143 patients and 2 stents inserted in 68. The successful rate of stent insertion was 98 6%, jaundice disappearing rate 84 8% and total effective rate 95 9%. One year survival rate was 48 3% and 17 6% in the combined treatment group and simple stenting group, respectively. The 2 year survival rate was 14 6% and 5 9% respectively in the 2 groups. There was significant difference in 1 year survival rate between the two groups. For the 52 patients with stent restenosis, 40 were managed with artery chemoembolization, drainage through percutaneous puncture or stenting in the stent and jaundice faded again. Conclusions 1) Biliary stent placement has high successful rate and reliable efficacy in releasing jaundice. 2) Both the left and right ductal system can be sufficiently drained and stent occlusion appropriately managed by interventional procedures. 3) Stent insertion combined with different anti cancer treatments can increase 1 year survival rate in the patients.