Palliative treatment for obstructive jaundice caused by unresectable malignancies by percutaneous transhepatic insertion of self-expandable metallic stents

Objective To determine the technical feasibility and clinical efficacy of self-expandable metallic stents for palliation of obstructive jaundice caused by unresectable malignancies. Methods A total of 105 patients with unresectable malignant tumors involving the bile duct who presented with obstructive jaundice underwent transhepatic implantation of self-expandable metallic stents. The follow-up period of the patients was 3-755 days. Technical and clinical success,adverse events,patient survival,and duration of stent patency were analyzed. Results Percutaneous biliary stenting was performed on 105 malignant biliary obstructive patients with 129 self-expandable metallic stents. Technical successful rate was 94.3%,and clinical success rate was 78%. Thirty-day mortality after stenting was 7.6%,not procedure-related. Median survival time and stent patency of all patients were 189 days and 246 days. Primary patency rates were 92.1% and 64.5% at 3 and 6 months,respectively. Conclusion Self-expandable metal wall stenting for malignant obstructive jaundice provides good palliation with low,procedure-related morbidity and mortality in the long term. Further investigation to identify the subgroup of patients in whom stenting has no beneficial effect would be required.