Cholecystitis After Metallic Stent Placement in Patients With Malignant Distal Biliary Obstruction

Isayama, Hiroyuki; Kawabe, Takao; Nakai, Yousuke; Tsujino, Takeshi; Sasahira, Naoki; Yamamoto, Natsuyo; Arizumi, Toshihiko; Togawa, Osamu; Matsubara, Saburou; Ito, Yukiko

doi:10.1016/j.cgh.2006.06.004

Cited by 156 publications

(126 citation statements)

References 28 publications

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“…Tumor involvement at the orifice of the CD, as in our case, is a risk factor for cholecystitis [2,3] . In patients in whom the cholecystitis does not resolve with conservative therapy, percutaneous cholecystostomy may be necessary [3] . In our patient, however, there was no window for percutaneous transhepatic drainage.…”

Section: Discussionsupporting

confidence: 51%

“…There is, however, a need to prevent and manage stent-related complications. Acute cholecystitis after SEMS placement is a serious complication, and tumor involvement at the orifice of the cystic duct (CD) is a risk factor [2,3] . Some patients with cholecystitis improve with conservative therapy, while others require percutaneous drainage.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic transpapillary gallbladder drainage with replacement of a covered self-expandable metal stent

Kawakubo

Isayama²,

Sasahira³

et al. 2011

WJGE

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Endoscopic selfexpandable metal stent (SEMS) place ment has become a standard palliative therapy for pa tients with malignant biliary obstruction. Acute cholecys titis after SEMS placement is a serious complication. We report a patient with an acute cholecystitis after covered SEMS placement, who was managed successfully with endoscopic transpapillary gallbladder drainage (ETGBD) and replacement of the covered SEMS. An 85yearold man with pancreatic cancer suffered from acute chole cystitis after covered SEMS placement. It was impossible to perform percutaneous transhepatic gallbladder drain age. After removal of the covered SEMS with a snare, a 7Fr double pigtail stent was placed between the gall bladder and duodenum, subsequently followed by an other covered SEMS insertion into the common bile duct beside the gallbladder stent. The cholecystitis improved immediately after ETGBD. ETGBD with replacement of the covered SEMS thus proved to be effective for treat ment of patients with acute cholecystitis after covered SEMS placement.

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Section: Discussionsupporting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Endoscopic transpapillary gallbladder drainage with replacement of a covered self-expandable metal stent

Kawakubo

Isayama²,

Sasahira³

et al. 2011

WJGE

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“…210 However multiple studies have shown that the primary risk for developing cholecystitis after ERCP is tumor involvement of the cystic duct orifice, regardless of whether a covered or uncovered metal stent is used. [211][212][213] Thus, whether cholecystitis occurs as a result of the stent itself versus the actual tumor biology is unclear. As the literature is not definitive it is not unreasonable for endoscopists to assess the location of the cystic duct orifice during ERCP to choose the appropriate length and size stent whose proximal end will terminate distal to the cystic take off.…”

Section: Risk Reductionmentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Tarnasky

Kedia

2017

Int J Gastrointest Interv

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Adverse events after endoscopic retrograde cholangiopancreatography (ERCP) are not uncommon and can be associated with tragic outcomes. Bleeding, perforation, and post-ERCP pancreatitis are the most common complications. Some events are unavoidable; others are associated with well described risk factors so that they can be either anticipated and/or measures can be taken for prevention or at least risk reduction. This review will focus on the more common complications after ERCP, their risk factors, and potential strategies for risk reduction. Additionally, recommendations for management of ERCP complications will be presented.

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“…Die Behandlung sollte anhand nichtinvasiver Bildgebung -am besten der MRCP -geplant und individuell durchge- [9,15,16]. Für den Wallstent fand sich kein signifikanter Unterschied in der Offenheitsrate [17], aber eine relativ hohe Komplikationsrate von 23,2% [18] und in einer prospektiven Studie eine hohe Cholezystitis-Häufigkeit von 10% [29].…”

Section: Cholangiocarcinoma: Update Of New Stents For Palliationunclassified

Gallengangskarzinom: Update neuer Stents zur Palliation

Schulz¹

2010

Viszeralmedizin

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Bei der Erstdiagnose eines Gallenwegskarzinoms ist der Tumor in den meisten Fällen nicht mehr operabel. In dieser Situation stellen endoskopisch oder perkutan implantierte Stents eine etablierte Palliation dar. Bei malignen Gallengangsstenosen können sowohl Plastikstents als auch Metallstents verwendet werden. Plastikstents werden oft bei Patienten mit sehr eingeschränkter Prognose bevorzugt. Metallendoprothesen zeigen deutlich höhere und verlängerte Offenheitsraten und erfordern signifikant weniger Reinterventionen und Stentwechsel. Fortschritte im Stentdesign haben zu einem erheblichen Anstieg der Implantationszahlen selbstexpandierender Metallstents geführt. Um dem Problem des Einwachsens von Tumorgewebe in den Stent zu begegnen, wurden vollbeschichtete Stents entwickelt. Die daraus resultierenden höheren Migrationsraten ließen sich durch einen Verzicht auf die Beschichtung der Stentenden vermindern. In naher Zukunft werden auch medikamentenbeschichtete und biologisch abbaubare Stents verfügbar sein. Auch wenn die Stenttherapie die bevorzugte Palliation bei Tumorerkrankungen im Gallenwegsbereich darstellt, wird der Patient dennoch von einer interdisziplinären Diskussion des Vorgehens unter Einbeziehung von Chirurgen und Onkologen profitieren.

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Cholecystitis After Metallic Stent Placement in Patients With Malignant Distal Biliary Obstruction

Cited by 156 publications

References 28 publications

Endoscopic transpapillary gallbladder drainage with replacement of a covered self-expandable metal stent

Endoscopic transpapillary gallbladder drainage with replacement of a covered self-expandable metal stent

Endoscopic retrograde cholangiopancreatography complications: Techniques to reduce risk and management strategies

Gallengangskarzinom: Update neuer Stents zur Palliation

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