BACKGROUND: This study audited the clinical outcome of a cohort of patients with choledocholithiasis treated with long-term biliary stenting in order to determine the feasibility of this practice. METHODS: Over 2 years, 83 patients with symptomatic choledocholithiasis were treated with long-term stenting because they either refused further treatments or were medically unfit for further procedures after the initial endoscopic retrograde cholangiopancreatography (ERCP). Recurrence of clinical events, need for stent change, morbidity, and mortality were analyzed. As a secondary analysis, published data on long-term biliary stenting were reviewed. RESULTS: ERCP and biliary stenting were successful in all cases with no complications. The mean follow-up was 19 months (1-103 months). The median number of ERCPs performed was 1 (1-4). The mean duration of stent patency was 12.4 months (1-54.8 months). A total of 28 clinical events (cholangitis, 71%) occurred in 24 patients during follow-up, for a late complication rate of 33.7%. ERCP was repeated and the stents changed on 15 occasions in 11 asymptomatic patients with abnormal liver function tests detected on routine follow-up. No biliary-related mortality occurred. Review of published data revealed a mean late complication rate of 22.4% (0%-64%), a biliary-related mortality rate of 3.5% (0%-21.1%), and a nonbiliary-related mortality rate of 20.8% (0%-60.3%). CONCLUSIONS: Long-term biliary stenting is a feasible option for patients who decline or are medically unfit for further elective endoscopic or surgical procedures. Close follow-up is mandatory to detect and treat late complications.
BACKGROUND: This study audited the clinical outcome of a cohort of patients with choledocholithiasis treated with long-term biliary stenting in order to determine the feasibility of this practice. METHODS: Over 2 years, 83 patients with symptomatic choledocholithiasis were treated with long-term stenting because they either refused further treatments or were medically unfit for further procedures after the initial endoscopic retrograde cholangiopancreatography (ERCP). Recurrence of clinical events, need for stent change, morbidity, and mortality were analyzed. As a secondary analysis, published data on long-term biliary stenting were reviewed. RESULTS: ERCP and biliary stenting were successful in all cases with no complications. The mean follow-up was 19 months (1-103 months). The median number of ERCPs performed was 1 (1-4). The mean duration of stent patency was 12.4 months (1-54.8 months). A total of 28 clinical events (cholangitis, 71%) occurred in 24 patients during follow-up, for a late complication rate of 33.7%. ERCP was repeated and the stents changed on 15 occasions in 11 asymptomatic patients with abnormal liver function tests detected on routine follow-up. No biliary-related mortality occurred. Review of published data revealed a mean late complication rate of 22.4% (0%-64%), a biliary-related mortality rate of 3.5% (0%-21.1%), and a nonbiliary-related mortality rate of 20.8% (0%-60.3%). CONCLUSIONS: Long-term biliary stenting is a feasible option for patients who decline or are medically unfit for further elective endoscopic or surgical procedures. Close follow-up is mandatory to detect and treat late complications.
Authors: P B Cotton; R A Kozarek; R H Schapiro; N S Nishioka; P B Kelsey; T J Ball; W S Putnam; A Barkun; J Weinerth Journal: Gastroenterology Date: 1990-10 Impact factor: 22.682
Authors: A Naranjo Rodríguez; J M Rodríguez Guerrero; M A Pérez Durán; J F de Dios Vega; G Miño Fugarolas Journal: Gastroenterol Hepatol Date: 1997-03 Impact factor: 2.102
Authors: D Vaira; L D'Anna; C Ainley; J Dowsett; S Williams; J Baillie; S Cairns; J Croker; P Salmon; P Cotton Journal: Lancet Date: 1989-08-19 Impact factor: 79.321
Authors: J C Pereira-Lima; R Jakobs; U H Winter; C Benz; W R Martin; H E Adamek; J F Riemann Journal: Gastrointest Endosc Date: 1998-11 Impact factor: 9.427
Authors: Mehmet Odabasi; Cem Arslan; Sami Akbulut; Haci Hasan Abuoglu; Erkan Ozkan; Mehmet Kamil Yildiz; Cengiz Eris; Emre Gunay; Kemal Tekesin; Tolga Muftuoglu Journal: Int J Clin Exp Med Date: 2014-08-15