Lack of complications following short-term stent therapy for extrahepatic bile duct strictures in primary sclerosing cholangitis

Gastrointest Endosc. 1997 Oct;46(4):344-7. doi: 10.1016/s0016-5107(97)70123-8.

Abstract

Background: In 10% to 20% of patients with primary sclerosing cholangitis, a dominant stricture of an extrahepatic bile duct is responsible for symptoms and an exacerbation of cholestasis. The complications of a dominant stricture can usually be relieved by endoscopic placement of a stent through the stricture. The conventional policy of leaving stents in situ for 2 to 3 months is associated with a high incidence (e.g., 50%) of clinical deterioration due to stent occlusion. We have attempted to overcome this problem by substantially reducing the duration of stent placement.

Methods: Sixteen patients with symptomatic primary sclerosing cholangitis and dominant extrahepatic bile duct strictures were treated by stent placement for a median interval of only 9 days.

Results: In all patients endoscopic stent therapy was technically successful with a 7% incidence of transient procedure-related complications. During median follow-up of 19 months (range 7 to 27 months) serum biochemical evidence of cholestasis decreased substantially and 13 (81%) of the 16 patients became asymptomatic. No patient had a recurrence or exacerbation of either symptoms or biochemical evidence of cholestasis that could be attributed to stent occlusion.

Conclusions: Short-term endoscopic stent therapy is a safe and effective treatment for symptomatic dominant extrahepatic bile duct strictures in patients with primary sclerosing cholangitis.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bile Ducts, Extrahepatic*
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholangitis, Sclerosing / complications*
  • Cholestasis, Extrahepatic / etiology
  • Cholestasis, Extrahepatic / therapy*
  • Endoscopy, Digestive System
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Stents / adverse effects*
  • Time Factors
  • Treatment Outcome