Interventional Endoscopy

Abstract

We report our experience with self-expandable nitinol coil stents (InStent, Inc.) (range 0.5-20).Results: Using EBS alone, the bile duct was cleared in 70 patients (76%). Mechanical lithotripsy was used to remove large stones (15-20 mm) in 13 (15%). Of the 20 EBS "failures" (24%) papillotomy was required to clear the duct in 7 (9%). A pigtail stent was inserted in 13 (15%) to maintain biliary drainage a) as a temporary measure because of doubt about residual stones >15 mm (n = 7, 9%), or b) as a definitive measure in elderly high risk patients with multiple stones >15 mm (n = 6, 6.5%). ERCP was repeated in 14 (16%) for stent removal ± replacement or repeat EBS-duct clearance (n = 4). There was no papillary haemorrhage, while uncomplicated pancreatitis was observed in 4 patients (5%).Conclusion: EBS is a safe and effective sphincter preservation technique for the management of BD stones up to 20 mm in size, which significantly reduces the need for papillotomy.