Permanent stenting in “unextractable” common bile duct stones in high risk patients. A prospective randomized study comparing two different stents

Pisello, F; Geraci, Girolamo; Volsi, Francesco Li; Modica, Giuseppe; Sciumè, C

doi:10.1007/s00423-008-0388-1

Cited by 38 publications

(30 citation statements)

References 33 publications

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“…Furthermore, a more prolonged procedure duration may be necessary to completely remove large/multiple stones in these frail, elderly patients. In such individuals, temporary biliary stenting is a safe and effective alternative (11)(12)(13)(14)(15)(16)18,19). In the present study, we confirmed our previous experience and earlier reports that biliary stenting might be associated with a decrease in stone size and stone fragmentation (14)(15)(16) and also that indwelling double stents are superior to a single stent in maintaining the 3-month stent patency rate.…”

Section: Discussionsupporting

confidence: 91%

“…Temporary plastic biliary stenting is a useful alternative when extraction techniques have failed to remove CBD stones completely, particularly in frail, elderly, and highrisk patients (11)(12)(13). Importantly, short-term use of biliary stenting has been shown to be associated with reduction in stone size or fragmentation and serves as a bridge treatment to secondary intervention, thereby leading to easier stone removal at follow-up endoscopy (14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness and safety of biliary stenting in the management of difficult common bile duct stones in elderly patients

Huai²,

Sun³

2016

Turk J Gastroenterol

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of biliary stenting in the management of difficult common bile duct stones in elderly patients

Huai²,

Sun³

2016

Turk J Gastroenterol

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“…For this reason, the use of longterm stenting should be limited to patients with a limited life expectancy. However, it has been reported that longterm stenting was effective in reducing the size of stones refractory to mechanical lithotripsy, and that complete elimination was achieved in 73.7-95.6% of cases when stone removal procedures were repeated after 3-6 months [135][136][137][138][139]. Even in patients given stents because stone removal had been difficult, complete stone removal may be achievable on retreatment; therefore reattempted stone removal is useful.…”

Section: Strength Of Recommendation (Agreement Rate): 2 (100%) Evidementioning

confidence: 99%

“…Even in patients given stents because stone removal had been difficult, complete stone removal may be achievable on retreatment; therefore reattempted stone removal is useful. Although RCTs have been conducted, comparison is difficult because of differences in the types of stents and oral medications used [136][137][138][139].…”

Section: Strength Of Recommendation (Agreement Rate): 2 (100%) Evidementioning

confidence: 99%

Evidence-based clinical practice guidelines for cholelithiasis 2016

Tazuma

Unno²,

Igarashi³

et al. 2016

J Gastroenterol

189

156

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Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Forty-three clinical questions, for four categories-epidemiology and pathogenesis, diagnosis, treatments, and prognosis and complications-were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This article preferentially describes the clinical management of cholelithiasis and its complications. Following description of the diagnosis performed stepwise through imaging modalities, treatments of cholecystolithiasis, choledocholithiasis, and hepatolithiasis are introduced along with a flowchart. Since there have been remarkable improvements in endoscopic treatments and surgical techniques, the guidelines ensure flexibility in choices according to the actual clinical environment. The revised clinical practice guidelines are appropriate for use by clinicians in their daily practice.

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“…8 The mean duration of the patency of the stent was about 12 months and the rate of late complications such as stent occlusion and cholangitis were 33.4-40.8%. [9][10][11][12] Most of the patients with stents in situ remain asymptomatic. However, inadequate follow up of the postoperative and post endoscopic period results in the formation of nidus around the stent and at times, cholangitis.…”

Section: Discussionmentioning

confidence: 99%

ERCP stent as a nidus for CBD stone: post cholecystectomy status

2017

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Obstruction of common bile duct due to a ‘Forgotten stent’ causing stone formation is a rare entity, which is usually associated with cholangitis. A much rarer presentation is our case with an ERCP stent forming a nidus for stone formation in the common bile duct without any evidence of cholangitis or bile duct obstruction. A 66-year-old female patient with a previous history of laparoscopic cholecystectomy and common bile duct stenting done 2 years back presented with vague abdominal pain, nausea and vomiting without features of jaundice or cholangitis. She was diagnosed on imaging as a case of choledocholithiasis with two stents in the common bile duct. A failed ERCP to extract the stent and relieve obstruction necessitated open choledochotomy, stents removal, common bile duct clearance and choledochoduodenostomy. The rarity of this patient with an ERCP acting as a nidus for common bile duct stones without evidence of obstruction or cholangitis is something to be documented. Although rare, these complications must always be considered and considered a possibility due to which post-operative and post-endoscopic follow up, regular check-ups and timely removal of the stents is necessary to avoid unnecessary complications or a need for repeat procedures and surgery that results in greater morbidity.

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Permanent stenting in “unextractable” common bile duct stones in high risk patients. A prospective randomized study comparing two different stents

Abstract: Endoprosthesis insertion as a permanent therapy is an effective alternative to surgery or dissolution therapy. Therefore, biliary stenting should preferably be restricted to high-risk patients unfit for operative treatment and with a short life expectancy.

Cited by 38 publications

References 33 publications

Effectiveness and safety of biliary stenting in the management of difficult common bile duct stones in elderly patients

Effectiveness and safety of biliary stenting in the management of difficult common bile duct stones in elderly patients

Evidence-based clinical practice guidelines for cholelithiasis 2016

ERCP stent as a nidus for CBD stone: post cholecystectomy status

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