Should a fully covered self-expandable biliary metal stent be anchored with a double-pigtail plastic stent? A retrospective study.
Biliary drainage
Biliary obstruction
Double-pigtail plastic stent
Endoscopic retrograde cholangiopancreatography
Metal stents
Journal
World journal of gastrointestinal endoscopy
ISSN: 1948-5190
Titre abrégé: World J Gastrointest Endosc
Pays: United States
ID NLM: 101532474
Informations de publication
Date de publication:
16 May 2019
16 May 2019
Historique:
received:
06
03
2019
revised:
30
04
2019
accepted:
10
05
2019
entrez:
18
6
2019
pubmed:
18
6
2019
medline:
18
6
2019
Statut:
ppublish
Résumé
The migration rate of fully covered self-expandable metal stents (FCSEMSs) has been reported to be between 14% to 37%. Anchoring of FCSEMSs using a double-pigtail plastic stent (DPS) may decrease migration. To compare stent migration rates between patients who received FCSEMS alone and those who received both an FCSEMS and anchoring DPS. We conducted a retrospective analysis of endoscopy reporting system and medical records of 1366 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with FCSEMS placement at the University of Kentucky health care. Between July 2015 and April 2017, 203 patients with FCSEMS insertion for the treatment of malignant biliary stricture, benign biliary stricture, post-sphincterotomy bleeding, bile leak, and cholangitis drainage were identified. The review and analysis were conducted through our endoscopy reporting system (ProVation 1366 patients had undergone ERCP by three advanced endoscopists over 21-mo period; among these, 203 patients had FCSEMSs placed. 65 patients had FCSEMSs with DPS, and 138 had FCSEMSs alone. 65 patients had FCSEMSs with DPS, and 138 had FCSEMSs alone. 95 patients had a malignant stricture, 82 patients had a benign stricture, 12 patients had bile leak, 12 patients had cholangitis, and nine patients had post-sphincterotomy bleeding. The migration rate in patients with anchored FCSEMSs with DPS was 6%, and those without anchoring DPS was 10% ( The risk of migration of biliary FCSEMS was 9.7 %. Anchoring an FCSEMS with DPS does not decrease the risk of stent migration.
Sections du résumé
BACKGROUND
BACKGROUND
The migration rate of fully covered self-expandable metal stents (FCSEMSs) has been reported to be between 14% to 37%. Anchoring of FCSEMSs using a double-pigtail plastic stent (DPS) may decrease migration.
AIM
OBJECTIVE
To compare stent migration rates between patients who received FCSEMS alone and those who received both an FCSEMS and anchoring DPS.
METHODS
METHODS
We conducted a retrospective analysis of endoscopy reporting system and medical records of 1366 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with FCSEMS placement at the University of Kentucky health care. Between July 2015 and April 2017, 203 patients with FCSEMS insertion for the treatment of malignant biliary stricture, benign biliary stricture, post-sphincterotomy bleeding, bile leak, and cholangitis drainage were identified. The review and analysis were conducted through our endoscopy reporting system (ProVation
RESULTS
RESULTS
1366 patients had undergone ERCP by three advanced endoscopists over 21-mo period; among these, 203 patients had FCSEMSs placed. 65 patients had FCSEMSs with DPS, and 138 had FCSEMSs alone. 65 patients had FCSEMSs with DPS, and 138 had FCSEMSs alone. 95 patients had a malignant stricture, 82 patients had a benign stricture, 12 patients had bile leak, 12 patients had cholangitis, and nine patients had post-sphincterotomy bleeding. The migration rate in patients with anchored FCSEMSs with DPS was 6%, and those without anchoring DPS was 10% (
CONCLUSION
CONCLUSIONS
The risk of migration of biliary FCSEMS was 9.7 %. Anchoring an FCSEMS with DPS does not decrease the risk of stent migration.
Identifiants
pubmed: 31205597
doi: 10.4253/wjge.v11.i5.365
pmc: PMC6556491
doi:
Types de publication
Journal Article
Langues
eng
Pagination
365-372Déclaration de conflit d'intérêts
Conflict-of-interest statement: The authors declare no conflicts of interest.
Références
Gut. 2004 May;53(5):729-34
pubmed: 15082593
Gastrointest Endosc. 2005 Apr;61(4):528-33
pubmed: 15812404
Clin Gastroenterol Hepatol. 2006 Sep;4(9):1148-53
pubmed: 16904950
Gastrointest Endosc. 2006 Oct;64(4):522-9
pubmed: 16996343
Gastrointest Endosc. 2009 Jul;70(1):37-44
pubmed: 19249766
Gastrointest Endosc. 2010 Jul;72(1):86-91
pubmed: 20493483
Gastrointest Endosc. 2011 Jan;73(1):64-70
pubmed: 21184871
Gastrointest Endosc. 2011 Aug;74(2):321-327.e1-3
pubmed: 21683354
Am J Gastroenterol. 2011 Oct;106(10):1761-5
pubmed: 21788992
Endoscopy. 2012 Mar;44(3):277-98
pubmed: 22297801
Gastrointest Endosc. 2013 Aug;78(2):312-24
pubmed: 23591331
Am J Gastroenterol. 2013 Nov;108(11):1713-22
pubmed: 24042190
Gut Liver. 2013 Nov;7(6):725-30
pubmed: 24312715
Ann Gastroenterol. 2017;30(1):114-117
pubmed: 28042247