The Thermodilator: An Effective Instrument in the Palliative Therapy Concept of Malignant Bile Duct Stenosis

Background and Methods: In the case of incurable malignant bile duct stenosis the aim of therapy is to secure the bile flow. Sometimes dilation of the stenosis is necessary to enable the introduction of a biliary duodenal stent or the replacement of a small-bore stent by a large-bore one. The previously most commonly used methods - bougienage and balloon dilation - can be unsuccessful with severe stenoses, which means that an extension of the endoscopic therapeutic instrumentarium is desirable. We examined the success rates and complications of a thermodilator which can be used to dilate bile duct stenoses.

Results and Conclusions: In 21 out of 24 applications the therapeutic objective was achieved. In one case we observed an endoscopically controllable bile duct hemorrhage. The thermodilator is therefore a valuable addition to the endoscopic treatment possibilities of malignant bile duct stenosis.