ERCP performed through previously placed duodenal stents: a multicenter retrospective study of outcomes and adverse events.
Gastrointest Endosc
; 87(6): 1499-1504, 2018 Jun.
Article
en En
| MEDLINE
| ID: mdl-29425886
ABSTRACT
BACKGROUND AND AIMS:
ERCP performed through previously placed enteral stents is an uncommon procedure without a significant amount of supporting literature and with a wide reported range of technical success. The purpose of this study was to evaluate and better define the technical feasibility and safety of performing ERCP through enteral stents in patients with combined malignant biliary and gastric outlet obstruction.METHODS:
We conducted a multicenter, retrospective study on 71 patients with combined gastric outlet and biliary obstruction who underwent ERCP through a previously placed enteral stent at 2 tertiary care centers. Outcomes included but were not limited to technical success, clinical success, need for repeat ERCP, adverse events, and survival time.RESULTS:
Overall technical success was achieved in 60 of 71 patients (85%), with technical success of 40 of 46 (87%) in type I obstructions (gastric outlet obstruction above the ampulla), 16 of 21 (76%) in type II obstructions (gastric outlet obstruction at the level of the ampulla), and 4 of 4 (100%) in type III obstructions (gastric outlet obstruction distal to the ampulla). In general, patients who achieved technical success also achieved clinical success. Adverse events occurred in 3 patients (3/71) 2 patients with acute cholangitis and 1 patient with perforation. Average survival time after the procedure was 4.6 months overall.CONCLUSIONS:
ERCP performed through enteral stents is safe, with a high technical and clinical success rate, but may be more technically challenging in the setting of type II obstructions. This procedure could be considered first line in the unique setting that a patient requires ERCP through a previously placed enteral stent for malignant gastric outlet and biliary obstruction.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Stents
/
Colestasis
/
Colangiopancreatografia Retrógrada Endoscópica
/
Obstrucción de la Salida Gástrica
/
Duodeno
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Gastrointest Endosc
Año:
2018
Tipo del documento:
Article
País de afiliación:
Estados Unidos