Endoscopy 2018; 50(04): S193-S194
DOI: 10.1055/s-0038-1637634
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

IS PLASTIC BILIARY STENTING IN CHOLEDOCHOLITHIASIS A LONG TIME SAFETY PROCEDURE? A RETROSPECTIVE MULTICENTRIC STUDY

E Quintanilla
1   Hospital Universitario Severo Ochoa, Madrid, Spain
,
LA Castillo
2   Hospital Universitario Infanta Elena, Madrid, Spain
,
M Delgado
2   Hospital Universitario Infanta Elena, Madrid, Spain
,
A Repiso
3   Hospital Universitario Vírgen de la Salud, Toledo, Spain
,
JL Castro
1   Hospital Universitario Severo Ochoa, Madrid, Spain
,
L Rábago
1   Hospital Universitario Severo Ochoa, Madrid, Spain
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
27. März 2018 (online)

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Aims:

Plastic biliary stenting in patients with choledocholithiasis is suitable until a second ERCP or surgery. This option has demonstrated the fragmentation and dissapearence of large size bile duct stones. Also, it is a simple and safe method for high-risk surgical patients.

Objetive: Value the effectiveness of plastic biliary stenting in patients with incomplete choledocholothiasis removal, as final technique or as a bridge for additional endoscopic or surgical intervention.

Methods:

Retrospective and multicentric study based on a review of ERCP performed between October 2005 and January 2015.

Results:

72 ERCP were enrolled (52 patients), 26 male and 26 female (50%). The size of plastic biliary stent usually used was 7 or 10 cm and 8,5Fr or 10Fr.

We established three groups of patients:

  • Plastic biliary stenting as definitive technique (n15, 28,8%) with an average age of 82. 33,3% of patients delivered biliary disease (4 cholangitis, 1 biliary colic) in an average time of 15,6 months

  • Plastic biliary stenting as a brigde for surgical intervention (n9, 17,3%). 33,3% of patients showed biliary disease (1 cholecystitis 6 months after initial placement, 1 pancreatitis 1 month after placement and 1 biliary colic, 18 months after).

  • Patients with additional ERCP (n28, 53,8%). 22 patients (78,2%) needed 2 ERCP getting stone fragmentation and/or removal in most cases (n17, 77,2%). 6 patients (21,5%) needed more than 2 ERCP to successfully resolve the bile duct obstruction in 83,3% (n5). Only 3 patients (10,7%) required a surgical intervention for the resolution of choledocholithiasis.

Conclusions:

The effectiveness of plastic biliary stenting are directly related with placement time. Plastic stent as a final option needs to be replaced annually. As a bridge for surgical intervention, this procedure should be carried out before 3 months. In patients with additional ERCP, it is an effective measure. Further studies are required to confirm this data.