Gastrointestinal Hemorrhage Due to Duodenal Erosion by a Biliary Wallstent

Roebuck, Derek J.; Stanley, Philip; Katz, Michael; Parry, Robert L.; Haight, Michael

doi:10.1007/s002709900213

Cited by 23 publications

(9 citation statements)

References 7 publications

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“…Although some authors have suggested that duodenal ulceration and subsequent bleeding or perforation of the duodenum, as well as both reflux of duodenal content into the bile duct (once believed to be a cause of early stent dysfunction) and pancreatitis are complications of the transpapillary method of stent placement, the cases they encountered were limited (12-15). In spite of concerns over these complications, most reports describing the long-term results of metallic stent insertion have demonstrated that their incidence is very low (2, 12).…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous Placement of Self-expandable Metallic Biliary Stents in Malignant Extrahepatic Strictures: Indications of Transpapillary and Suprapapillary Methods

Lee

Hwang

et al. 2000

Korean J Radiol

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ObjectiveTo compare the efficacy of suprapapillary and transpapillary methods of transhepatic biliary metallic stent placement in malignant biliary strictures and to specify the indications of each method applied.Materials and MethodsStents were placed in 59 patients. Strictures were categorized as type A (within 3 cm of the ampulla, n = 27), type B (over 3 cm from ampulla, n = 7), type C (within 3 cm of the bending portion, n = 9), or type D (over 3 cm above the bending portion, n=16). The stenting method was suprapapillary in 34 cases and transpapillary in 25. The rates of initial and long-term patency and of early recurrence were compared.ResultsInitial patency rates for the suprapapillary and transpapillary methods were 1/7 (14.3%) and 20/20 (100%) respectively for type A (p < 0.0001), 4/5 (80.0%) and 2/2 for type B, 3/7 (42.9%) and 2/2 for type C, and 15/16 (93.8%) and 0/0 for type D. Early recurrence rates were 7/30 (23.3%) using the suprapapillary method and 4/29 (13.8%) using the transpapillary method (p = 0.51). The long-term patency rate did not differ significantly according to either type (p = 0.37) or method (p = 0.62).ConclusionFor good initial patency, the transpapillary method is recommended for strictures of the distal extrahepatic duct near the ampulla and just above the bending portion. Long-term patency is not influenced by the stenting method employed.

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Section: Discussionmentioning

confidence: 99%

“…In spite of concerns over these complications, most reports describing the long-term results of metallic stent insertion have demonstrated that their incidence is very low (2, 12). Interestingly, most reports of bleeding involved cases in which the prototype Wallstent was used (15).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Placement of Self-expandable Metallic Biliary Stents in Malignant Extrahepatic Strictures: Indications of Transpapillary and Suprapapillary Methods

Lee

Hwang

et al. 2000

Korean J Radiol

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“…The majority of stent-related complications involve stent occlusion, leading to cholangitis. Displacement of the stent in the duodenal wall, which is another complication, is not only associated with occlusion but also with the formation of erosions and ulcers from mechanical irritation, and serious bleeding and gastrointestinal tract perforation [3][4][5] . An intervention for stent occlusion is mechanical cleaning, using devices such as a balloon, but, the occlusion recurs in a comparatively short time in many cases [6] .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic removal and trimming of distal self-expandable metallic biliary stents

Ishii

Itoi²,

Sofuni

et al. 2011

WJG

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AIM:To evaluate the efficacy and safety of endoscopic removal and trimming of self-expandable metallic stents (SEMS). METHODS:All SEMS had been placed for distal biliary strictures. Twenty-seven endoscopic procedures were performed in 19 patients in whom SEMS (one uncovered and 18 covered) removal had been attempted, and 8 patients in whom stent trimming using argon plasma coagulation (APC) had been attempted at Tokyo Medical University Hospital. The APC settings were: voltage 60-80 W and gas flow at 1.5 L/min. RESULTS:The mean stent indwelling period for all patients in whom stent removal had been attempted was 113.7 ± 77.6 d (range, 8-280 d). Of the 19 patients in whom removal of the SEMS had been attempted, the procedure was successful in 14 (73.7%) without procedure-related adverse events. The indwelling period in the stent removable group was shorter than that in the unremovable group (94.9 ± 71.5 d vs 166.2 ± 76.2 d, P = 0.08). Stent trimming was successful for all patients with one minor adverse event consisting of self-limited hemorrhage. Trimming time ranged from 11 to 16 min. CONCLUSION:Although further investigations on larger numbers of cases are necessary to accumulate evidence, the present data suggested that stent removal and stent trimming is feasible and effective for stent-related complications.

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“…Urinary tract obstruction can be palliated by interventional radiology by nephrostomy or antegrade ureteric stenting [34]. Palliation of malignant obstructive jaundice with permanent metallic stents is rarely required in childhood, although there are reports of a few procedures [31,[35][36][37].…”

Section: Other Palliative Proceduresmentioning

confidence: 99%

Interventional radiology in paediatric palliative care

Roebuck

2014

Pediatr Radiol

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Paediatric palliative care is a distinct subspecialty that offers treatment to children with many types of illness, including oncological, neurological and respiratory problems. Paediatric interventional radiologists can make a useful contribution to symptom management as part of a multidisciplinary team. Interventions for pain management include local ablation or other treatment of painful lesions, image-guided nerve blocks and the insertion of devices for the delivery of analgesic drugs. Various techniques are also available for the management of ascites, pleural effusions and other symptomatic complications of the underlying disease process.

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Gastrointestinal Hemorrhage Due to Duodenal Erosion by a Biliary Wallstent

Cited by 23 publications

References 7 publications

Percutaneous Placement of Self-expandable Metallic Biliary Stents in Malignant Extrahepatic Strictures: Indications of Transpapillary and Suprapapillary Methods

Percutaneous Placement of Self-expandable Metallic Biliary Stents in Malignant Extrahepatic Strictures: Indications of Transpapillary and Suprapapillary Methods

Endoscopic removal and trimming of distal self-expandable metallic biliary stents

Interventional radiology in paediatric palliative care

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