eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
Current issue Archive Videoforum Manuscripts accepted About the journal Supplements Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank


3/2017
vol. 12
 
Share:
Share:
more
 
 
abstract:
Original paper

Multiple plastic biliary stent placement in the management of large and multiple choledochal stones: single center experience and review of the literature

Hasan Bektaş
,
Bünyamin Gürbulak
,
Zeynep Deniz Şahin
,
Yiğit Düzköylü
,
Şükrü Çolak
,
Esin Kabul Gürbulak
,
Mehmet Emin Güneş
,
Ekrem Çakar

Videosurgery Miniinv 2017; 12 (3): 231–237
Online publish date: 2017/07/19
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is the first step treatment modality of choledocholithiasis. In spite of an extended sphincterotomy, 10–15% of complex choledochal stones (larger than 15 mm and/or more than 3 stones) cannot be removed and recurrent ERCP procedures may be needed.

Aim: To evaluate the role and efficiency of multiple biliary stent application in the treatment of large and multiple choledochal stones.

Material and methods: Patients with complex choledochal stones and patients with inadequate choledochal clearance during ERCP were included in the study. The study group was divided into 2 groups as the placement of single (n = 27 patients) or multiple stents (n = 58 patients). After a mean time interval of 21 days (10–28), the ERCP procedure was tried for the second time and a stent was placed in case of recurrence.

Results: Successful biliary drainage was provided in both groups. The decrease in the longitudinal or transverse size of the stones after stent placement was found to be statistically significant in both groups (p = 0.001). Cholestatic enzymes (alkaline phosphatase (ALP), γ-glutamyltransferase (GGT)) and bilirubin levels decreased significantly in both groups following stenting (p = 0.001). Additionally, multiple stents functioned as a bridge starting from the first ERCP to full clearance in patients with large and multiple stones which could not be removed at once and saved them from the possible morbidities of an invasive operation.

Conclusions: Endoscopic multiple biliary stent placement should be preferred in the treatment of patients with complex choledochal stones and high rates of co-morbidity, as a safe alternative to surgery.

keywords:

endoscopic retrograde cholangiopancreatography (ERCP), choledocholithiasis, multiple plastic biliary stents

  
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe