Predictors and outcomes of delayed plastic biliary stent removal following endoscopic retrograde cholangiopancreatography

Abstract

Almost one-fifth of patients who underwent ERCP with plastic biliary stent placement had delayed removal with nearly one-fifth of these patients requiring hospitalization for stent obstruction. Targeting patients at risk by improving communication and ease of scheduling an ERCP may reduce preventable adverse events associated with delayed biliary stent removal.

A rare case of massive hepatic abscess 6 years after ERCP due to retained biliary stent

“…Patient's adherence to follow-up is crucial. Regular appointments should be scheduled every 2-6 months after the initial insertion of endoprosthesis, and continues until the removal of the biliary stent (1)(2)(3)(4)11). Biliary stents are foreign bodies and, therefore, if kept for a prolonged period they contribute to formation of stones in the CBD and bacterial proliferation (3)(4)(5)(6)(7)(8)(9)(10)(11)(12).…”

“…Endoscopic retrograde cholangiopancreatography (ERCP) is widely accepted as the gold standard technique for the treatment of choledocholithiasis and, is usually combined with the endoscopic insertion of biliary endoprosthesis in order to establish and secure patency of the common bile duct (CBD) (1,2). Biliary stents are tubular devices made of plastic or metal, and is recommended to be replaced or removed within 2-6 months from insertion (1)(2)(3)(4).…”

“…Retained biliary stents for a prolonged period without follow up may cause serious, or even life-threatening, complications such as acute cholangitis, pancreatitis, internal stent migration, endoprosthesis occlusion and obstructive jaundice (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In these cases, the mortality rate can reach up to 12% (3). The formation of liver abscess is a rare complication of a forgotten stent in the CBD.…”

Biodegradable biliopancreatic stents could help conserve health care resources during the COVID-19 pandemic: An observational multicenter study

“…At present, plastic and self-expandable metal stents are most widely used [1 , 2] . While they are safe and effective, the necessity of follow-up (for, e.g., radiological evaluation of passage, endoscopic exchange or removal) is a disadvantage [2] , [3] , [4] , 6] . On the one hand, these procedures are an organizational and financial burden for hospitals and patients.…”

“…On the one hand, these procedures are an organizational and financial burden for hospitals and patients. On the other hand, failure to retrieve stents can cause adverse events, like stent obstruction and cholangitis [2 , [5] , [6] , [7] , [8] , [9] .…”