Fully Covered Metal Stents Safely Facilitate Extraction of Difficult Bile Duct Stones


Koksal A. S., Eminler A. T., PARLAK E.

Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, cilt.33, sa.2, ss.152-161, 2023 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 33 Sayı: 2
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1097/sle.0000000000001147
  • Dergi Adı: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.152-161
  • Anahtar Kelimeler: bile duct stone, fully covered metal stent, ERCP
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Background: Ten to 15% of the common bile duct (CBD) stones require advanced endoscopic extraction techniques during endoscopic retrograde cholangiopancreatography. The study aimed to evaluate the efficacy and safety of fully covered self-expandable metal stents (FC-SEMS) for facilitating the extraction of difficult bile duct stones. Methods: Patients who received FC-SEMS for the extraction of difficult CBD stones were retrospectively reviewed. Group 1 included patients with extrahepatic stones above a distal CBD stricture, Group 2 included patients with intrahepatic stones above a hilar stricture, and Group 3 included patients with complex stone(s) and no biliary stricture. Complete stone clearance rate and complications of FC-SEMS treatment were evaluated. Results: The study group included 33 procedures on 32 patients (mean age: 55±17, 56.3% male). FC-SEMS was placed as a primary treatment in 15 (45.5%) procedures. Complete stone clearance was achieved in 84.6% of the procedures in Group 1, 100% in Group 2, and 87.5% in Group 3 (P=0.23). Overall, complete stone clearance was achieved in 30 of the 33 procedures (90.9%). None of the patients developed pancreatitis, cholecystitis, or cholangitis. Stent migration occurred in 4 procedures (12.1%), and all were clinically insignificant. Conclusion: FC-SEMS is effective and safe for facilitating treatment of difficult bile duct stones.