Retrograde stenting of the bile ducts for benign hepatopancreatoduodenal diseases

Abstract

Aim.To evaluate the immediate results of endoscopic retrograde stenting of bile ducts in benign hepatopancreatoduodenal diseases and to justify enlargement of indications for surgery.Material and methods.There were 341 patients with various benign hepatopancreatoduodenal diseases for the period 2007–2017. Plastic stents were installed in 326 (95.6%) patients, metal self-expanding stents – in 15 (4.4%) patients.Results.There was a tendency to increase of the number of stenting procedures in patients with benign hepatopancreatoduodenal diseases that was primarily due to expansion of indications for this intervention. Therapeutic and prophylactic purposes of biliary stenting were determined. The main objectives of therapeutic stenting were bile drainage restoration in obstructive jaundice, reduction of extra- and intrahepatic biliary pressure, as well as drainage of cavities in liver communicating with biliary system. The main prophylactic goal was to prevent violation of bile outflow after endoscopic manipulations on the major duodenal papilla at high risk of migration of stones from gallbladder and reflux cholangitis. Severe complications of endoscopic transpapillary procedures were not observed.Conclusion.The indications for endoscopic transpapillary stenting of the bile ducts in case of benign hepatopancreatoduodenal diseases were systematized and reasonably expanded. Immediate results of biliary stenting confirm high efficacy of the method.