Endoscopic sphincterotomy, nasobiliary drainage and biliary stent placement without image intensification

1993 ◽  
Vol 80 (6) ◽  
pp. 807-807
Author(s):  
P. B. Cotton ◽  
S. P. Misra
Keyword(s):  
Stent Placement ◽  
Endoscopic Sphincterotomy ◽  
Biliary Stent ◽  
Image Intensification ◽  
Nasobiliary Drainage

scholarly journals Biliary Stent Placement without Endoscopic Sphincterotomy in Patients with Common Bile Duct Stones

GastroHep ◽  
2021 ◽  
Author(s):  
Aye‐Mya‐Mya Kyaw ◽  
Than‐Than Aye ◽  
Khin‐San Aye ◽  
Wai‐Phyo Aung ◽  
Thet‐Mar Win
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Stent Placement ◽  
Endoscopic Sphincterotomy ◽  
Common Bile Duct Stones ◽  
Biliary Stent ◽  
Bile Duct Stones

Biliary stent placement over a standard papillotomy knife

2011 ◽  
Vol 24 (01) ◽  
Author(s):  
A Weber ◽  
S von Delius ◽  
RM Schmid ◽  
A Meining
Keyword(s):  
Stent Placement ◽  
Biliary Stent

scholarly journals A85 THE CLINICAL IMPACT OF COVID-19 DELAYS ON PLASTIC BILIARY STENT REMOVAL IN NOVA SCOTIA

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 54-56
Author(s):  
D R Lim ◽  
M Tsai ◽  
S E Gruchy ◽  
J Jones ◽  
G Williams ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Nova Scotia ◽  
Stent Placement ◽  
Biliary Stent ◽  
Biliary Stents ◽  
Stent Occlusion ◽  
Stent Removal ◽  
Kaplan Meier ◽  
And Migration

Abstract Background The COVID-2019 pandemic continues to restrict access to endoscopy, resulting in delays or cancellation of non-urgent endoscopic procedures. A delay in the removal or exchange of plastic biliary stents may lead to stent occlusion with consensus recommendation of stent removal or exchange at three-month intervals [1–4]. We postulated that delayed plastic biliary stent removal (DPBSR) would increase complication rates. Aims We aim to report our single-centre experience with complications arising from DPBSR. Methods This was a retrospective, single-center, observational cohort study. All subjects who had ERCP-guided plastic biliary stent placement in Halifax, Nova Scotia between Dec 2019 and June 2020 were included in the study. DPBSR was defined as stent removal >=90 days from insertion. Four endpoints were assigned to patients: 1. Stent removed endoscopically, 2. Died with stent in-situ (measured from stent placement to documented date of death/last clinical encounter before death), 3. Pending removal (subjects clinically well, no liver enzyme elevation, not expired, endpoint 1 Nov 2020), and 4. Complication requiring urgent reintervention. Kaplan-Meier survival analysis was used to represent duration of stent patency (Fig.1). Results 102 (47.2%) had plastic biliary stents placed between 2/12/2019 and 29/6/2020. 49 (48%) were female, and the median age was 68 (R 16–91). Median follow-up was 167.5 days, 60 (58.8%) subjects had stent removal, 12 (11.8%) died before replacement, 21 (20.6%) were awaiting stent removal with no complications (median 230d, R 30–332), 9 (8.8%) had complications requiring urgent ERCP. Based on death reports, no deaths were related to stent-related complications. 72(70.6%) of patients had stents in-situ for >= 90 days. In this population, median time to removal was 211.5d (R 91-441d). 3 (4.2%) subjects had stent-related complications requiring urgent ERCP, mean time to complication was 218.3d (R 94–441). Stent removal >=90 days was not associated with complications such as occlusion, cholangitis, and migration (p=1.0). Days of stent in-situ was not associated with occlusion, cholangitis, and migration (p=0.57). Sex (p=0.275), cholecystectomy (p=1.0), cholangiocarcinoma (p=1.0), cholangitis (p=0.68) or pancreatitis (p=1.0) six weeks prior to ERCP, benign vs. malignant etiology (p=1.0) were not significantly associated with stent-related complications. Conclusions Plastic biliary stent longevity may have been previously underestimated. The findings of this study agree with CAG framework recommendations [5] that stent removal be prioritized as elective (P3). Limitations include small sample size that could affect Kaplan-Meier survival analysis. Despite prolonged indwelling stent time as a result of COVID-19, we did not observe an increased incidence of stent occlusion or other complications. Funding Agencies None

scholarly journals Short-Term Biliary Stent Placement Contributing Common Bile Duct Stone Disappearance with Preservation of Duodenal Papilla Function

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Tatsuki Ueda ◽  
Masataka Kikuyama ◽  
Yuzo Kodama ◽  
Takafumi Kurokami
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Stent Placement ◽  
Bile Ducts ◽  
Common Bile Duct Stones ◽  
Biliary Stent ◽  
Duodenal Papilla ◽  
Short Term ◽  
Endoscopic Retrograde ◽  
Obstructive Cholangitis

Aims. To investigate the effect of biliary stent placement without endoscopic sphincterotomy (EST) on common bile duct stones (CBDS) disappearance and the contribution of preserving the duodenal papilla function to reduce recurrence of CBDS.Methods. Sixty-six patients admitted for acute obstructive cholangitis due to CBDS who underwent biliary stent placement without EST for 2 years from March 2011 were evaluated retrospectively. The second endoscopic retrograde cholangiopancreatography (ERCP) was performed for treatment of CBDS 3 to 4 months after the first ERCP. We estimated the rate of stone disappearance at the time of second ERCP.Results. CBDS disappearance was observed in 32 (48.5%) of 66 patients. The diameter of the bile ducts and the diameter of CBDS in patients with CBDS disappearance were significantly smaller than in those with CBDS requiring extraction (p=0.007andp<0.001, resp.). Stone disappearance was evident when the diameter of bile ducts and that of CBDS were <10 and 7 mm, respectively (p=0.002).Conclusions. Short-term stent placement without EST eliminates CBDS while preserving duodenal papilla function and may be suitable for treating CBDS in patients with nondilated bile ducts and small CBDS.

scholarly journals Complications due to Biliary Stent Deviation

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Kinoshita Kumar ◽  
◽  
Fukuchi S ◽  
Murakami K ◽  
◽  
...  
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sphincterotomy ◽  
Clinical Symptoms ◽  
Acute Cholangitis ◽  
Biliary Stent ◽  
Plastic Stents ◽  
Duodenal Perforation ◽  
Early Complications ◽  
Biliary Stents ◽  
Uterine Appendage

We often encounter complications from biliary stents used as a treatment for obstructive jaundice and acute cholangitis. Early complications after stent placement include pancreatitis, bleeding, and duodenal perforation [1]. Stent deviation is also a complication. This is particularly prominent for plastic stents, where stent deviation is observed in 6-18.7 % of cases [2]. Stent deviation is more common among patients who have undergone endoscopic sphincterotomy (Figure 1). Most deviated biliary plastic stents are excreted in stool or collected endoscopically, but, very rarely, complications causing gastrointestinal perforation have been reported. We have described deviated biliary plastic stents causing sigmoid colon diverticulum perforation and even uterine appendage penetration (Figure 2). Diagnosis can be made from clinical symptoms and abdominal computed tomography. Treatment is basically surgery. Biliary stent-related complications are inevitable, and sometimes become serious. On suspicion of such complications, the most important issue is to accurately and rapidly diagnose complications and conduct appropriate management.

scholarly journals Spontaneous Choledochoduodenal Fistula after Metallic Biliary Stent Placement in a Patient with Ampulla of Vater Carcinoma

Gut and Liver ◽  
2009 ◽  
Vol 3 (4) ◽  
pp. 360-363 ◽  
Author(s):  
Tae Hoon Lee ◽  
Sang-Heum Park ◽  
Sang Pil Kim ◽  
Sae Hwan Lee ◽  
Chang-Kyun Lee ◽  
...  
Keyword(s):  
Stent Placement ◽  
Ampulla Of Vater ◽  
Biliary Stent ◽  
Choledochoduodenal Fistula

scholarly journals Irreversible Electroporation Treatment With Intraoperative Biliary Stenting for Unresectable Perihilar Cholangiocarcinoma: A Pilot Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Po-Chih Yang ◽  
Yan-Jun Chen ◽  
Xiao-Yong Li ◽  
Chih-Yang Hsiao ◽  
Bing-Bing Cheng ◽  
...  
Keyword(s):  
Stent Placement ◽  
Irreversible Electroporation ◽  
Progression Free Survival ◽  
Carbohydrate Antigen ◽  
Biliary Stent ◽  
Perihilar Cholangiocarcinoma ◽  
Total Serum ◽  
Medical Centers ◽  
Serum Carbohydrate Antigen ◽  
One Year

BackgroundTreating perihilar cholangiocarcinoma (PHCC) is particularly difficult due to the fact that it is usually in an advanced stage at the time of diagnosis. Irreversible electroporation treatment (IRE) involves the local administration of a high-voltage electric current to target lesions without causing damage to surrounding structures. This study investigated the safety and efficacy of using IRE in conjunction with intraoperative biliary stent placement in cases of unresectable PHCC.MethodsThis study enrolled 17 patients with unresectable Bismuth type III/IV PHCC who underwent IRE in conjunction with intraoperative biliary stent placement (laparotomic) in two medical centers in Asia between June 2015 and July 2018. Analysis focused on the perioperative clinical course, the efficacy of biliary decompression, and outcomes (survival).ResultsMean total serum bilirubin levels (mg/dL) on postoperative day (POD) 7, POD30, and POD90 were significantly lower than before IRE (respectively 3.46 vs 4.54, p=0.007; 1.21 vs 4.54, p&lt;0.001; 1.99 vs 4.54, p&lt;0.001). Mean serum carbohydrate antigen 19-9 (CA19-9, U/ml) levels were significantly higher on POD3 than before the operation (518.8 vs 372.4, p=0.001) and significantly lower on POD30 and POD90 (respectively 113.7 vs 372.4, p&lt;0.001; 63.9 vs 372.4, p&lt;0.001). No cases of Clavien-Dindo grade III/IV adverse events or mortality occurred within 90 days post-op. The median progression-free survival was 21.5 months, and the median overall survival was 27.9 months. All individuals who survived for at least one year did so without the need to carry percutaneous biliary drainage (PTBD) tubes.ConclusionsIt appears that IRE treatment in conjunction with intraoperative biliary stent placement is a safe and effective approach to treating unresectable PHCC. The decompression of biliary obstruction without the need for PTBD tubes is also expected to improve the quality of life of patients.

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