Abstract No. 91: Use of ePTFE Covered Stents for Malignant Biliary Strictures

Abstract

Enthusiasm for bare metallic stents for malignant biliary strictures has waned due to increased rates of occlusion requiring secondary intervention. To this end, there has been greater application of covered biliary endostents for this purpose. We intend to demonstrate both patency and need for secondary interventions with the use of ePTFE convered biliary endostents for malignant biliary strictures. Retrospective chart review was used to identify placement of 28 ePTFE covered endostents for malignant biliary strictures as palliation between May 10, 2005 and June 20, 2007. Patient records were then utilized to document patient outcome post stent placement. The Social Security Death Index (SSDI) was then used to ascertain the cause and date of patient expiry. From this, patency values were determined and Kaplan Meier curves derieved. The cohort (n=28) consisted of 15 males and 13 females. The underlying neoplasm for the majority was pancreatic adenocarcinoma (25/28) with gastric, gallbladder and small cell carcinomas of the liver and pancreas comprising the remainder. The mean age at stent deployment was 65.6 years. Stent patency ranged from 11-530 days. The median patency of the biliary endostent was 126 days. From the cohort, 26 of 28 patients (93%) required no further intervention for stent occlusion. Only one patient (3%) presented with an occluded stent requiring secondary intervention after 259 days. The final patient of the cohort is currently alive with a stent patency of 586 days. ePTFE covered biliary endostent for malignant biliary stricture palliation demonstrates a high primary patency rate (96%) suggesting stent patency outlives patient survival. The low secondary intervention rate (n=1, 3%) suggests the notion that palliation may be achieved satisfactorily with covered biliary endostents.