Gastrointestinal endoscopy · 1997
Lack of complications following short-term stent therapy for extrahepatic bile duct strictures in primary sclerosing cholangitis.
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van Milligen de Wit A W, Rauws E A, van Bracht J, Mulder C J, Jones E A, Tytgat G N, Huibregtse K
Аннотация
BACKGROUND: In 10% to 20% of patients with primary sclerosing cholangitis, a dominant stricture of an extrahepatic bile duct is responsible for symptoms and an exacerbation of cholestasis. The complications of a dominant stricture can usually be relieved by endoscopic placement of a stent through the stricture. The conventional policy of leaving stents in situ for 2 to 3 months is associated with a high incidence (e.g., 50%) of clinical deterioration due to stent occlusion. We have attempted to overcome this problem by substantially reducing the duration of stent placement.
METHODS: Sixteen patients with symptomatic primary sclerosing cholangitis and dominant extrahepatic bile duct strictures were treated by stent placement for a median interval of only 9 days.
RESULTS: In all patients endoscopic stent therapy was technically successful with a 7% incidence of transient procedure-related complications. During median follow-up of 19 months (range 7 to 27 months) serum biochemical evidence of cholestasis decreased substantially and 13 (81%) of the 16 patients became asymptomatic. No patient had a recurrence or exacerbation of either symptoms or biochemical evidence of cholestasis that could be attributed to stent occlusion.
CONCLUSIONS: Short-term endoscopic stent therapy is a safe and effective treatment for symptomatic dominant extrahepatic bile duct strictures in patients with primary sclerosing cholangitis.
METHODS: Sixteen patients with symptomatic primary sclerosing cholangitis and dominant extrahepatic bile duct strictures were treated by stent placement for a median interval of only 9 days.
RESULTS: In all patients endoscopic stent therapy was technically successful with a 7% incidence of transient procedure-related complications. During median follow-up of 19 months (range 7 to 27 months) serum biochemical evidence of cholestasis decreased substantially and 13 (81%) of the 16 patients became asymptomatic. No patient had a recurrence or exacerbation of either symptoms or biochemical evidence of cholestasis that could be attributed to stent occlusion.
CONCLUSIONS: Short-term endoscopic stent therapy is a safe and effective treatment for symptomatic dominant extrahepatic bile duct strictures in patients with primary sclerosing cholangitis.