Endoscopic management of malignant biliary strictures: RAFH experience

ABSTRACT

To evaluate endoscopic management in patients with malignant biliary strictures. Retrospective study of all patients with malignant biliary strictures, who had endoscopic diagnosis and/or management between 1980 and 1993. During 14 years, 123 patients with malignant biliary strictures, had endoscopic diagnosis and management at the Gastroenterology Department, Armed Forces Hospital, Riyadh. Interventions: All patients had diagnostic endoscopic retrograde cholangiopancreatography [ERCP] and if possible sphincterotomy, nasobiliary tube insertion or biliary stricture dilatation and stent insertion to relieve biliary obstruction. Some patients were referred for surgery. Of these patients, 68 had cholangiocarcinoma, nine had gall bladder carcinoma, 16 had pancreatic head carcinoma, 23 had papillary carcinoma and seven had metastatic carcinoma. In 73 patients, biliary drainage was achieved endoscopically using nasobiliary tubes in 26 patients, plastic stents in 37 patients and expandable metal stents in 10 patients. In 13 patients only sphincterotomy or endoscopic choledochoduodenostomy were done. In the remaining 37 patients only diagnostic ERCP was done but endoscopic drainage was not possible and they were referred for surgery