An audit of the outcome of long-term biliary stenting in the treatment of common bile duct stones in a general hospital

Fock, Kwong Ming; Teo, Eng Kiong; Chua, Tju Siang; Tan, Jessica

doi:10.1007/s00535-006-1849-3

Cited by 41 publications

(41 citation statements)

References 37 publications

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“…This result is in agreement with data reported from a Japanese study in which 13% of patients suffered cholangitis during biliary stenting [23] . Comparing this with long-term biliary stenting, Ang et al [24] reported up to 22% mortality among patients treated by long-term biliary stenting for an average of 12 mo (range: 1-54 mo), which accounted for 3.5% of biliary-related mortality. However, there was no mortality in the present study.…”

Section: Discussionmentioning

confidence: 99%

Failure of sequential biliary stenting for unsuccessful common bile duct stone removal

Prachayakul

Aswakul²

2013

WJGE

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AIM:To determine the factors associated with the failure of stone removal by a biliary stenting strategy. METHODS:We retrospectively reviewed 645 patients with common bile duct (CBD) stones who underwent endoscopic retrograde cholangiography for stone removal in Siriraj GI Endoscopy center, Siriraj Hospital from June 2009 to June 2012. A total of 42 patients with unsuccessful initial removal of large CBD stones that underwent sequential biliary stenting were enrolled in the present study. The demographic data, laboratory results, stone characteristics, procedure details, and clinical outcomes were recorded and analyzed. In addition, the patients were classified into two groups based on outcome, successful or failed sequential biliary stenting, and the above factors were compared. RESULTS:Among the initial 42 patients with unsuccessful initial removal of large CBD stones, there were 37 successful biliary stenting cases and five failed cases. Complete CBD clearance was achieved in 88.0% of cases. The average number of sessions needed before complete stone removal was achieved was 2.43 at an average of 25 wk after the first procedure. Complications during the follow-up period occurred in 19.1% of cases, comprising ascending cholangitis (14.3%) and pancreatitis (4.8%). The factors associated with failure of complete CBD stone clearance in the biliary stenting group were unchanged CBD stone size after the first biliary stenting attempt (10.2 wk) and a greater number of endoscopic retrograde cholangio-pancreatography sessions performed (4.2 sessions). CONCLUSION:The sequential biliary stenting is an effective management strategy for the failure of initial large CBD stone removal. Key words: Endoscopic retrograde cholangiography; Common bile duct stone; Biliary stenting; Large common bile duct stone; Biliary stenting failure Core tip: This study was a retrospective review of 42 patients who underwent sequential biliary stenting following a failed removal of a large common bile duct stone by endoscopic retrograde cholangiopancreatography. Complete common bile duct (CBD) clearance was achieved in 88% of the patients at 25 wk after the first procedure, while 19% reported complications. The common complications were cholangitis and pancreatitis. The factors associated with the failure of this strategy were unchanged CBD stone size at the second biliary stenting attempt, and more endoscopic retrograde cholangio-pancreatography sessions performed.Prachayakul V, Aswakul P. Failure of sequential biliary stenting for unsuccessful common bile duct stone removal. World J Gastrointest Endosc 2013; 5(6): 288-292 Available from: URL:

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Section: Discussionmentioning

confidence: 99%

Failure of sequential biliary stenting for unsuccessful common bile duct stone removal

Prachayakul

Aswakul²

2013

WJGE

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“…If general condition of patients permits, periodical stent exchange seems desirable. Although the optimal exchange interval has not been established, annual exchange may be acceptable because Ang et al (22) reported in their review article that the mean duration of stent patency was 12.4 months. Our results support this interval.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Therapeutic ERCP for the Elderly with Choledocholithiasis: Comparison with Younger Patients

et al. 2010

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Objective To clarify the efficacy and safety of therapeutic endoscopic retrograde cholangiopancreatography for the elderly with choledocholithiasis compared with younger patients. Methods Consecutive therapeutic ERCPs performed between 2005 and 2007 at our institution for 118 patients aged 80 years or older (group A) and 205 patients younger than 80 years old (group B) were retrospectively reviewed. Successful cannulation rate, complete stone clearance rate, complications and prognosis were compared between the two groups. Results Successful cannulation was achieved in 99.2% in group A versus 99.5% in group B. The complete stone clearance rate was significantly lower in group A than in group B (92.4% versus 99.0%, p<0.01). Plastic stent placement was performed for patients with incomplete duct clearance. There was no significant difference in the early complication rate between group A (5.5%) and group B (6.6%). Procedure-related mortality did not occur. Cholangitis-free survival was similar between the two groups. The short-term prognosis was comparable between those with complete duct clearance and those with biliary stent placement. Conclusion With a duct clearance rate of more than 90% and plastic stent placement for patients with poor general condition, therapeutic ERCP for choledocholithiasis in patients 80 years of age or older is comparable in safety and effectiveness to that in younger patients.

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“…2,[5][6][7][8][9][10][11][12][13] In those difficult cases, placement of temporary biliary endoprotheses to maintain adequate biliary drainage have been used as a bridge to subsequent interventions. [14][15][16][17] The use of covered self-expandable metal stents (CSEMSs) in benign disease is increasing, but few have explored their role in complex stone cases. Based on previous use, it can be hypothesized that CSEMSs could have an advantage over plastic stents in improving subsequent duct clearance.…”

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confidence: 99%

Complex biliary stones: treatment with removable self-expandable metal stents: a new approach (with videos)

Cerefice

Sauer

Javaid

et al. 2011

Gastrointestinal Endoscopy

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An audit of the outcome of long-term biliary stenting in the treatment of common bile duct stones in a general hospital

Abstract: 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.

Cited by 41 publications

References 37 publications

Failure of sequential biliary stenting for unsuccessful common bile duct stone removal

Failure of sequential biliary stenting for unsuccessful common bile duct stone removal

Efficacy and Safety of Therapeutic ERCP for the Elderly with Choledocholithiasis: Comparison with Younger Patients

Complex biliary stones: treatment with removable self-expandable metal stents: a new approach (with videos)

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