Posters

Palliation of obstructive jaundice can be done with surgical bypass, endoscopic stent insertion percutaneous transhepatic stent insertion. Self expanding metal stent have recently been proposed as better alternative for treatment of bile duct obstruction. This study was set up to evaluate follow. up results of the metal stents in our hospital. MATERIAL AND METHODS.33 Patients with obstructive jaundice treated with percutaneous transhepatic metal stent insertion at the Doce de Octubre Hospital, Madrid, Spain were reviewed. There were 12 women and 21 men, aged 37-87 years(mean age 64.4 years). Biliary obstruction was caused by pancreatic carcinoma (n= 7), cholangiocarcinoma (n= 9), gallbladder carcinoma(n=4), metastatic lymphadenectomy (n=5), hepaticojejunostomie strictures(n=4) and others (n=4). The histopathological diagnosis was proven in 21 patients. The indications for stent insertion included 4 hepaticojejunostomie strictures, 16 advanced diseases, unresecable tumors, medical opinion, 2 high ASA. External or internal biliary drainage was established during first session in all patients. Stent insertion was successfull in 32 patients. RESULTS. Effective biliary decompression was accomplished in 23 patients, but only of them had complete relief of jaundice. Early morbidity was 17.1% (bacteriemia 3, wound infection i, hemobilia i) and late complications were 12.1% Cholangitis 2, stent oclusion 2). 30-day mortality rate was of 12.1%. The overall mean survival was 58 weeks 19.5 standard desviation. The median post stent hospital stay was 9.1 (range 1-33 days). CONCLUSIONS. Metal stent in biliary tree is useful palliative treatment for those patients with malignant obstructive jaundice when estimated operative risk is high there is advanced disease. Hospital stay is low and quality of survival is better with relief of jaundice and pruritus. OBSTRUCTIVE JAUNDICE DUE TO NODAL METASTASES SHOULD WE PALLIATE BY PERCUTANEOUS STENTING? N Do.c.tor, Helen Whiteway, A Salamat, J Dooley, R Dick, B Davidson. Hepatobiliary Unit, Royal Free Hospital, London