Abstract | BACKGROUND: METHODS: We evaluated the efficacy of the sequential insertion of multiple stents in the treatment of endoscopic biliary sphincterotomy associated common bile duct strictures. The design of the study is a prospective, single-arm observational study at a university-affiliated teaching hospital of 20 patients with distal common bile duct strictures because of choledocholithiasis-related endoscopic biliary sphincterotomy. Endoscopic treatment consisted of the sequential insertion of an increasing number of plastic stents with ever-larger diameters in 3-month follow-up intervals until stricture resolution. The primary outcome of the study was the rate of resolution of the stricture. The parameters measured were the duration of placement of stents, the maximum diameter, the total number of stents, and the total number of endoscopic sessions required for dilation of the strictures. RESULTS: After a median of 9.0 months of stent placement (range 3-22 months) and a median of 20F maximum stent diameter (range 10F-30F), 18 patients (90%) remained stent-free for a median of 14.5 months (range 6-38 months). Two patients (10%) had stricture recurrences at 10 and 24 months. Multivariate regression analysis demonstrated that the time elapsed after endoscopic biliary sphincterotomy was significantly associated with the stent-placement time (however, significance was removed by correction for multiple testing) and the number of ERCPs required for dilation. The initial common bile duct size was significantly associated with the total stent number and diameter needed for stricture resolution (however, significance was removed by correction for multiple testing). Limitations are the low case number and the single-arm, noncontrolled study design. CONCLUSIONS:
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Authors | József Pozsár, Péter Sahin, Ferenc László, Lajos Topa |
Journal | Gastrointestinal endoscopy
(Gastrointest Endosc)
Vol. 62
Issue 1
Pg. 85-91
(Jul 2005)
ISSN: 0016-5107 [Print] United States |
PMID | 15990824
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Biocompatible Materials
- Plastics
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Biocompatible Materials
- Cholangiopancreatography, Endoscopic Retrograde
(methods)
- Cholestasis, Extrahepatic
(pathology, surgery)
- Common Bile Duct
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Plastics
- Prospective Studies
- Prosthesis Design
- Prosthesis Implantation
(instrumentation)
- Stents
- Time Factors
- Treatment Outcome
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