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. 2019 Nov;52(6):598-605.
doi: 10.5946/ce.2018.177. Epub 2019 May 28.

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

Ga Hee Kim  1 , Si Kyong Ryoo  1 , Jae Keun Park  2 , Joo Kyung Park  2 , Kwang Hyuck Lee  2 , Kyu Taek Lee  2 , Jong Kyun Lee  2
Affiliations

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

Ga Hee Kim et al. Clin Endosc. 2019 Nov.

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.

Conclusion: 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.

Keywords: Cholecystitis; Endoscopic retrograde biliary drainage; Pancreatitis; Type of stent.

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Conflict of interest statement

Conflicts of Interest:The authors have no financial conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Selection of the study population.
See this image and copyright information in PMC

References

    1. Smith AC, Dowsett JF, Russell RC, Hatfield AR, Cotton PB. Randomised trial of endoscopic stenting versus surgical bypass in malignant low bileduct obstruction. Lancet. 1994;344:1655–1660. - PubMed
    1. ASGE Technology Assessment Committee. Pfau PR, Pleskow DK, et al. Pancreatic and biliary stents. Gastrointest Endosc. 2013;77:319–327. - PubMed
    1. Isayama H, Kawabe T, Nakai Y, et al. Cholecystitis after metallic stent placement in patients with malignant distal biliary obstruction. Clin Gastroenterol Hepatol. 2006;4:1148–1153. - PubMed
    1. Isayama H, Komatsu Y, Tsujino T, et al. A prospective randomised study of “covered” versus “uncovered” diamond stents for the management of distal malignant biliary obstruction. Gut. 2004;53:729–734. - PMC - PubMed
    1. Sawas T, Al Halabi S, Parsi MA, Vargo JJ. Self-expandable metal stents versus plastic stents for malignant biliary obstruction: a meta-analysis. Gastrointest Endosc. 2015;82:256–267.e7. - PubMed

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