Endoscopic stenting for malignant biliary obstruction is technically successful in patients with preexisting duodenal stents Journal Article
| Authors: | Simoes, P. K.; Schattner, M. A.; Gerdes, H.; Shah, P. M.; Kurtz, R. C.; Mendelsohn, R. B. |
| Article Title: | Endoscopic stenting for malignant biliary obstruction is technically successful in patients with preexisting duodenal stents |
| Abstract: | Background and study aims There are limited data on the success of endoscopic retrograde cholangiopancreatography (ERCP) in patients with malignant biliary and duodenal obstruction with a preexisting duodenal stent. The aim of this study was to evaluate patient and procedural outcomes of a cohort of patients with preexisting duodenal stents who underwent an attempt at ERCP for malignant biliary obstruction (MBO). Patients and methods This was a single-center retrospective study on consecutive patients with a preexisting duodenal stent who underwent attempted ERCP for MBO. Technical success was defined as successful cannulation of the common bile duct, with successful dilation and/or deployment of a biliary stent under fluoroscopy. Clinical success was defined as number of patients in the entire group who underwent ERCP successfully with resolution of symptoms. Results We identified 64 patients (73% men, 74% white, median age 62 years) with a preexisting duodenal stent who underwent 85 attempts at ERCP. ERCP was technically successful in 50 of 85 procedures (59%). Overall ERCP was successful in 41 of 85 patients (48%). ERCP was more likely to be successful in patients with Type 1 and 3 duodenal strictures than with Type 2 strictures (83% and 92% vs. 42%, P<0.01), in patients with a preexisting sphincterotomy (79% vs. 20%, P = 0.01) or preexisting biliary stent (66% vs. 34%, P = 0.04). Adverse events included bleeding (n = 3), post-procedure fever (n = 3) and abdominal pain (n = 1). Conclusions Although biliary stenting via ERCP is often technically challenging in patients with a prior duodenal stent, it is a safe and effective method of biliary drainage. ERCP should be attempted in patients with Type 1 and 3 duodenal strictures, a prior sphincterotomy or an indwelling biliary stent. |
| Keywords: | drainage; predictors; palliation; multicenter; adverse events; expandable metal stents; failed ercp |
| Journal Title: | Endoscopy International Open |
| Volume: | 10 |
| Issue: | 4 |
| ISSN: | 2364-3722 |
| Publisher: | Georg Thieme Verlag Kg |
| Date Published: | 2022-04-01 |
| Start Page: | E429 |
| End Page: | E433 |
| Language: | English |
| ACCESSION: | WOS:000782488600024 |
| DOI: | 10.1055/a-1783-9310 |
| PROVIDER: | wos |
| PMCID: | PMC9010099 |
| PUBMED: | 35433215 |
| Notes: | Article -- Source: Wos |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
-
176Gerdes -
75Mendelsohn -
169Schattner -
196Kurtz -
47Shah
Related MSK Work