Clin Endosc.  2019 Nov;52(6):598-605. 10.5946/ce.2018.177.

Risk Factors for Pancreatitis and Cholecystitis after Endoscopic Biliary Stenting in Patients with Malignant Extrahepatic Bile Duct Obstruction

Affiliations
  • 1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Department of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jongk.lee@samsung.com

Abstract

BACKGROUND/AIMS
For the treatment of malignant biliary obstruction, endoscopic retrograde biliary drainage (ERBD) has been widely accepted as a standard procedure. However, post-ERBD complications can affect the lives of patients. The purpose of this study was to identify the predictive factors for these complications, including the patient's status, cancer status, and stent type.
METHODS
This was a retrospective analysis conducted in a single tertiary hospital from January 2007 to July 2017. The following variables were evaluated: sex, age, body mass index, cancer type, history of pancreatitis, gallbladder stone, previous biliary stenting, precut papillotomy, stent type, contrast injection into the pancreatic duct or gallbladder, cystic duct invasion by the tumor, and occlusion of the cystic duct orifice by a metal stent.
RESULTS
Multivariate analysis showed that contrast injection into the pancreatic duct was a risk factor for pancreatitis. Patients with a history of bile drainage showed a lower risk of pancreatitis. For cholecystitis, the analysis revealed contrast injection into the gallbladder and cystic duct invasion by the tumor as important predictive factors. Metal stents showed a greater risk of post-procedure pancreatitis than plastic stents, but did not affect the incidence of cholecystitis.
CONCLUSIONS
Considering that contrast injection is the most important factor for both complications, a careful approach by the physician is essential in preventing the occurrence of any complications. Further, choosing the type of stent is an important factor for patients at a risk of post-procedure pancreatitis.

Keyword

Cholecystitis; Endoscopic retrograde biliary drainage; Pancreatitis; Type of stent

MeSH Terms

Bile
Bile Ducts, Extrahepatic*
Body Mass Index
Cholecystitis*
Cystic Duct
Drainage
Gallbladder
Humans
Incidence
Multivariate Analysis
Pancreatic Ducts
Pancreatitis*
Plastics
Retrospective Studies
Risk Factors*
Stents*
Tertiary Care Centers
Plastics

Figure

  • Fig. 1. Selection of the study population.


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Clin Endosc. 2019;52(6):525-526.    doi: 10.5946/ce.2019.197.

The feasibility of percutaneous transhepatic gallbladder aspiration for acute cholecystitis after self-expandable metallic stent placement for malignant biliary obstruction: a 10-year retrospective analysis in a single center
Akihisa Ohno, Nao Fujimori, Toyoma Kaku, Masayuki Hijioka, Ken Kawabe, Naohiko Harada, Makoto Nakamuta, Takamasa Oono, Yoshihiro Ogawa
Clin Endosc. 2022;55(6):784-792.    doi: 10.5946/ce.2021.244.

How should a therapeutic strategy be constructed for acute cholecystitis after self-expanding metal stent placement for malignant biliary obstruction?
Mamoru Takenaka, Masatoshi Kudo
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