Two Cases of Malignant Biliary Obstruction Successfully Treated by Using Expandable Metallic Endoprosthesis after Radiotherapy

Atsushi Tanaka, Jounji Iseki, Nobuaki Nakajima*, Kenji Suzuki, Minoru Watanabe, Kouji Hakamada, Masakazu Takagi, Kazuhiko Nakagami, Kazushige Tohyama

The Department of Surgery and the Department of Radiology*, Shizuoka General Hospital

Two cases of biliary drainage by insertion of an expandable metallic stent after external or intraluminal irradiation are reported. In case 1 the patient was a 61-year-old man with obstructive jaundice due to extension of hepatic metastasis after total gastrectomy for gastric cancer. After 50 Gy of external irradiation, the bile duct was recanalized and an expandable metallic stent was inserted. In case 2 the patient was a 78-year-old man with obstructive jaundice due to cholangiocellular carcinoma. After 28 Gy of external irradiation, intraluminal irradiation by means of ⁶⁰Co remote afterloading system (RALS) was performed, and an expandable metallic stent was inserted. Both patients were discharged from the hospital without drainage tubes. For malignant obstructive jaundice with no indication for resection, the combination of radiotherapy and an expandable metallic endoprosthesis is useful for improving the quality of life of the patients.

Key words
malignant biliary obstruction, remote afterloading system, expandable metallic stent

Reprint requests
Atsushi Tanaka Okamura Memorial Hospital
260-3 Nagasawa, Shimizu-cho, Suntou-gun, Shizuoka, 411 JAPAN

Accepted
July 6, 1992

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