Benign bile-duct stenoses - Treatment with self-expanding metallic stents or silicon prostheses (Yamakava) in inoperable stenoses or high operative risk cases [Benigne Gallenwegstenosen: Behandlung mit flexiblen Metallgitterstents oder Silikonprothesen (Yamakava) bei nichtresezierbaren Stenosen oder hohem Operationsrisiko]

Introduction: High benign biliary stenoses, which can occur as a complication of disease or surgery, may be difficult to correct by open surgery and may also carry a high risk. An alternative to surgery is the percutaneous implantation of a flexible metallic stent or silicon prosthesis at the affected site. Methods: Twelve patients with benign biliary stenoses have been operated on in our department since March 1992, and the therapeutic success was reviewed in this study. Results: Six received a Palmaz stent and six a silicon prosthesis, with a follow-up after completion of treatment of more than 7 years and more than 3 years, respectively. Fifty percent of the patients with a stent experienced no problems and 66 % of the stents remained patent (including one requiring operative intervention to restore patency). No further surgery was necessary in any of the patients with a silicon prosthesis. Conclusion: When the advantages and disadvantages of the various procedures are considered, long-term splinting with a wide-lumened silicon prosthesis (Yamakava) appears to be a promising alternative to surgery for the treatment of benign biliary stenosis.