Nintinol Self-Expandable Metallic Stenting in Management of Malignant Obstructive Jaundice: A Case Series

Palliation therapy is the only available therapeutic method for most patients with tumor-inducedobstructive jaundice. metallic stents are now performed percutaneously as an alternative route to the endoscopic approach.it is widely accepted because of its safety, good patency rate, and minimal invasiveness. this study was designedto evaluate the long-term results of metallic self-expandable stent insertion in patients with malignant stenosis of thebiliary tree.methods: it is a longitudinal study of patients with percutaneously biliary stenting from september 2005 to march 2009.the patients had unresectable malignant biliary obstruction with unsuccessful endoscopic stenting and access. percutaneoustranshepatic cholangiogram performed after adequate local anesthesia, under sonographic or fluoroscopic guidance.stenting or balloon dilation was performed through the hydrophilic guide wire. among 50 patients, 45 stents wereplaced in biliary tree stenosis sites. patients’ follow-up was during the first, second, third, and then the sixth month afterinsertion of biliary stents. stent patency was considered successful in our patients, when there were no lab results orsonographic appearance of biliary tree obstruction.results: 10(20%) patients’ stent placement treatment failed because of unsuccessful technical procedure. the stenosisof biliary tract was complete and passage of guide wire was not possible through the tumor growth. 6 (15 %) patientswith successful stent placements died within one month (mean, 22 days). total serum bilirubin resolved to below 1.5mg/dl within 30 days for 36 (90%) patients with successful stent placements. early complications not leading to deathoccurred in 28% of cases. the mean survival time for all patients who underwent stent placement was 140 days (16-420days). the mean patency rate for all stents was 147 days.conclusions: percutaneous biliary stenting is a safe procedure with few technical complications and a high success rateof palliation for patients with malignant biliary jaundice. early complications are mostly managed conservatively anddeath is mainly due to systemic effects of the malignant disease.