Primary patency of percutaneously inserted self-expanding metallic stents in patients with malignant biliary obstruction

Background: Effective bile duct drainage is crucial to the health-related quality of life of patients with jaundice caused by obstruction of the bile duct by inoperable malignant tumours.

Methods: All patients who were treated at Uppsala University Hospital, Sweden with percutaneous stenting between 2000 and 2005 were identified retrospectively. Data on the location of the obstruction and type of stent used, date and cause of death and date of stent failure were abstracted from the patients' notes. Stent patency was defined as the duration from the insertion of the stent to the date of failure. In cases in which the cause of death was directly related to failure of the stent, the date of death was defined as the patency endpoint.

Results: A total of 64 patients (34 women, 30 men) were identified. Their mean age was 71 years (standard deviation 11 years). The median length of patency was 11.4 months. Stent diameter >10 mm and distal stricture were found to be associated with significantly longer patency time in univariate Cox proportional hazard analysis. In multivariate Cox proportional hazard analysis, only location of the stricture was found to be independently and significantly associated with patency time.

Discussion: Percutaneous stenting is a good alternative for patients with obstructive jaundice and a life expectancy ≤1 year. It may give instant relief from the symptoms associated with jaundice. Patency time may be prolonged by using stents with a diameter ≥10 mm. However, patency time was found to be lower for hilar tumours.