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Effects of metal versus plastic stent in the palliative treatment of malignant biliary obstruction

DAI Fang,HUANG Xin hua,CHEN Yong,et al.Department of Radiology,PLA No.210 Hospital of Dalian,Liaoning 116021.P.R.China  
Objective:To compare the effects and patency time of percutanous trsanshepatic metal versus plastic stents in the palliative treatment of malignant biliary obstruction and to study the indications of two kinds of biliary endoprostheses.Methods:The clincal data of 45 metal stents and 34 plastic stents in the treatment of malignant obstructive jaundice were analyzed retrospectively.Results:There were remarkable effects on reducing the level of serum bilirubin and improving the symptoms.The bilirubin decreased more obviously in the first week,and tended to normal in 3 weeks.The early complications were few; late complications were mainly blockage of the stent.Median stent patency was 276 days in metal stent versus 112 days in plastic stent ( P 0.01).Conclusion:Two types of stents are efficient means of treating malignant biliary strictures and reducing the level of serum bilirubin,particularly of upper biliary obstructions.The patency time of metal stent is much longer than that of plastic stent,but the former is more expansive.Therefore metal stent should be scheduled for those patients who will live longer than 3 months;if patient is impoverished or/and whose survival time be shorter (than 3 months),the doctor could employ plastic stent.
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