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

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.

• Authors: K Kiehne, U R Fölsch, R Nitsche
• Journal: Endoscopy (Endoscopy) Vol. 32 Issue 5 Pg. 377-80 (May 2000) ISSN: 0013-726X [Print] Germany
• PMID: 10817175 (Publication Type: Comparative Study, Journal Article)

Topics

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