An audit of percutaneous biliary stenting for the palliation of pancreatic cancer: Results, post-procedural survival period, and comparison of plastic and mental stents

Abstract

The purpose of this retrospective study was to assess the patient survival period after palliative biliary stenting and to compare different kinds of stents used. During a 27-month period, 60 patients received palliative percutaneous biliary stents for obstructive jaundice due to carcinoma of the head of the pancreas. During the first procedure 17 patients received (metal) Wall stents (mean age 59.8 years, range 32 - 77 years), and 43 patients received (plastic) Carey Coons stents (mean age 62.3 years, range 31 - 87 years). In 12 patients the stent had to be replaced due to complications and 1 patient had a second replacement. All replacement stents were plastic except in 2 cases. Two out of 17 (11.7%) metal stents and 10 out of 43 (23.2%) plastic stents had to be replaced. The median post-procedural survival period was determined between the date of procedure and the date of death. There was a marked clinical improvement of jaundice in all patients with their follow-up within a few days. More plastic stents were replaced. The average post-procedural survival period for 41 patients was 85.6 days, which is on par with internationally accepted survival periods. The most cost-effective biliary stent must be used for palliation because of the very short survival rate of this disease. For patients with no surgical options this procedure yields excellent results in comparison with the high morbidity and mortality rates of palliative surgical bypass procedures.