Prevalence of and risk factors for stent migration-induced duodenal perforation
| Autor: | D. de Jong, Pieter J F de Jonge, Marco J. Bruno, Jan-Werner Poley, Pauline M.C. Stassen |
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| Přispěvatelé: | Gastroenterology & Hepatology |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Original article
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Perforation (oil well) Clinical course Stent Retrospective cohort study equipment and supplies Asymptomatic Endoscopy Surgery surgical procedures operative medicine Pharmacology (medical) lcsh:Diseases of the digestive system. Gastroenterology cardiovascular diseases medicine.symptom lcsh:RC799-869 Complication business Duodenal Perforation |
| Zdroj: | Endoscopy International Open, Vol 09, Iss 03, Pp E461-E469 (2021) Endoscopy International Open Endoscopy International Open, 09(03), E461-E469. Georg Thieme Verlag |
| ISSN: | 2196-9736 2364-3722 |
| Popis: | Background and study aims The safety of transpapillary biliary drainage by stent placement through endoscopic retrograde cholangiography (ERC) may be compromised by the occurrence of stent migration-induced perforation of the duodenal wall (SMDP). We aimed to assess the prevalence rate, risk factors and clinical course of SMDP.Patients and methods This retrospective cohort study included all patients who underwent an ERC with biliary plastic stent placement, between January 2014 and December 2018. Patients with an SMDP were identified from our endoscopy complication registry.Results 1227 patients underwent an ERC, of whom 629 patients (51 %) with biliary plastic stent placement; in 304 patients (25 %) stents were placed for perihilar strictures. Thirteen patients with SMDP were identified. The prevalence was 2.1 % for patients with biliary plastic stent placement and 4.3 % for patients stented for a perihilar stricture. All SMDPs occurred in patients with a perihilar stricture and with stents ≥ 12 cm (range 12–20 cm). Another potential risk factor was stent insertion into the left liver lobe, which was present in 10 of 13 patients. In 10 of 13 patients, SMDP was clinically suspected. Three of 13 patients were asymptomatic and diagnosed at elective stent retrieval. Eight patients could be endoscopically treated with an over-the-scope clip. Four patients died due to abdominal sepsis despite repeated interventions.Conclusion SMDP is a rare but potentially life-threatening complication of ERC after transpapillary drainage for perihilar biliary strictures. Stents ≥ 12 cm and stent insertion into the left liver lobe may be associated risk factors. |
| Databáze: | OpenAIRE |
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