Biliary stent occlusion

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Published Jun 18, 2010
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Vol. 88 No. 7 (2010): Issue Jul 2010

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Dalila Gargouri
Service de Gastro-entérologie Hôpital H. Thameur Tunis
Asma Kochlef
Asma Ouekaa
Hela Elloumi
Afef Kilani
Malika Romani
Jamel Kharrat
Abdeljabbar Ghorbel

Abstract

Background : Endoscopic stent insertion is as a method of choice for palliative treatment of malignant biliary strictures. Two types of biliary stent were actually used plastic and metallic self-expandable. Occlusion of the stent can be observed in both.
Aim: To assess the management of biliary stent occlusion.
Methods : From january 2006 to december 2007, 120 biliary stents were inserted in 97 patients. Indications of biliary stents were malignant stricture in 67% of cases. Biliary stent occlusion was defined by necessity of stent replacement.
Results: 118 plastic and 2 metallic self-expandable biliary stents were inserted. Obstruction of the biliary stent was observed in 12 patients, after a mean time of 5,5 months [1-15]. A recurrent biliary desobstruction was necessary in 6 patients. Stent exchange was realised in 33,3% of cases for malignant biliary stenosis and in 66,6% for benign stricture (p=0,01). Obstruction of the stent was symptomatic (cholangitis, jaundice) in more of 50% of cases.
Management consisted on the stent exchange by a new plastic stent for clogging plastic stent and on insertion of plastic stent inside the metallic one for the occluded metallic stent.
Conclusion : Obstruction can occur for the two types of biliary stent. Survival of the patient, cost of the stent guide the choice of the stent will be used.

Keywords:

Biliary obstruction, , ERCP, biliary stent

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