High complication rate of bile duct stents in patients with chronic alcoholic pancreatitis due to noncompliance

Endoscopy. 2000 May;32(5):377-80. doi: 10.1055/s-2000-9004.

Abstract

Background and study aims: Biliary obstruction in chronic pancreatitis is frequently treated by endoscopic insertion of a plastic stent into the common bile duct, a therapy regarded as having a low complication rate. The aim of this study is to analyze the frequency and severity of complications caused by biliary stents in patients with chronic alcoholic pancreatitis.

Patients and methods: We retrospectively analyzed all our patients with chronic pancreatitis (n = 14) who were provided with a plastic stent for biliary stenosis between June 1993 and December 1997. Stent exchanges were followed until December 1998.

Results: Stent insertion was performed without early complications and was successful in each patient. Only two patients were admitted after 3-4 months at the scheduled dates for stent exchange, both without complications. In one of these patients, the bile duct stenosis was reopened after two stent exchanges over a total period of 8 months. Most of our patients (n=12) did not come at the arranged dates for stent exchange. They were repeatedly admitted (mean 2.9 times/patient, range 1-5) as emergency cases with severe complications of biliary obstruction, such as cholangitis or biliary sepsis. Reopening of the bile duct stenosis was not achieved in these patients.

Conclusions: We associate the high rate of complications with the noncompliance of our patients, who were all alcoholics. The high incidence of late complications in noncompliant patients is a limitation of biliary stenting, and appears to be potentially harmful.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cholangiopancreatography, Endoscopic Retrograde*
  • Cholestasis, Extrahepatic / diagnosis
  • Cholestasis, Extrahepatic / etiology
  • Cholestasis, Extrahepatic / surgery*
  • Common Bile Duct* / diagnostic imaging
  • Common Bile Duct* / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatitis, Alcoholic / complications*
  • Patient Compliance*
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / surgery
  • Reoperation
  • Retrospective Studies
  • Stents / adverse effects*
  • Treatment Outcome
  • Ultrasonography