Value analysis of endoscopic management of malignant obstruction combined common bile duct and gastric outlet-duodenum obstruction

Abstract

Objective To evaluate curative effects of treatment of malignant biliary and gastric out-let-duodenal obstruction with endoscopicaUy placed self-expandahle metal stents. Methods A retrospective analysis was performed in 17 patients who underwent enteral stenting after placement of the biliary stent. The success rate of insertion, the effective palliation of biliary and duodenal obstruction, the rate of complication, recurrent stent obstruction and the median patency were observed. Results In 17 patients, biliary stenting were all performed for obstructive jaundice and then enteral stents were inserted. The levels of tatal billiru-bin [from （263.4 ± 62.5 ） p, moL/L to （ 157.6 ± 25.1 ） μmol/L], direct billirubin [ from （ 1233.2 ± 66.5） μmol/L to （ 130.9 ± 27.7 ） μmol/L ] and alkaline phosphatase [ from （ 233.2 ± 66. 5 ） IU/L to （130. 9 ±27.7）IU/L] decreased significantly （P 〈 0. 01 ）, and the gastric outlet score increased signifi- cantly [ from （0. 9 ± 1.1 ） points to （2. 1 ± 0. 7 ） points ] （P 〈 0. 01 ）. No serious complication in all pa-tients. Lifetime of patients ranged from 70 days to 332 days, and the median survival time was 192 day. Conclusion Combined biliary and enteral stenting is an effective method for palliation of malignant biliary and gastric outlet-duodenal obstruction. Key words: Biliary tract neoplasms ; Cholangiopancreatography, endoscopic retrograde ; Stent ; Malignant biliary obstruction; Malignant duodenal obstruction