Biliary drainage endoprostheses: experience with 201 placements.

Two hundred one biliary endoprostheses were inserted transhepatically with a two-step procedure in 162 patients. Teflon endoprostheses were inserted in the initial 95 patients and polyethylene in seven others. Because in vitro experiments and clinical experience have revealed a lower incrustation rate with Percuflex and polyurethane, endoprostheses made of these materials were used in the last 60 patients. The mortality rate directly related to the procedure was 3.7%, and postprocedural complications occurred in 9% of the patients. Delayed complications included cholangitis in 20%, obstruction in 6%, and dislocation in 3% of the cases. The mean survival time of all 162 patients was 20 weeks. It is concluded that endoprostheses offer effective palliative treatment of obstructive jaundice caused by malignancy.