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Biliary sphincterotomy is not required for bile duct stent placement
Author(s) -
Wilcox C. Mel,
Kim Hwasoon,
Ramesh Jayapal,
Trevino Jessica,
Varadarajulu Shyam
Publication year - 2014
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12058
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , bile duct , stent , biliary stent , pancreatitis , surgery , common bile duct , radiology
Background The aim of the present study was to assess the success and outcome of bile duct stent placement without the use of endoscopic biliary sphincterotomy ( EBS ). Patients and Methods Over a period of 10 years and 9 months, all patients undergoing endoscopic retrograde cholangiopancreatography ( ERCP ) were prospectively identified. Bile duct stent placement was routinely done without EBS unless additional therapy (stone removal, multiple stenting) was anticipated. Results Of 5020 patients who underwent ERCP , bile duct stents were placed in 1668 patients. After excluding those requiring additional endoscopic therapy, 1112 patients (89.5%) had ERCP and stent placement without a sphincterotomy and 130 patients (10.5%) had ERCP and stent placement with asphincterotomy. Deployed endoprostheses were self‐expandable metallic stents in 15.7% and plastic in 77.5%. Caliber of plastic stents was 10 F r in 78.9% and <10 F r in 21.1%. All stents were successfully placed in these 1112 patients without the need for EBS . Comparing patients undergoing bile duct stenting with and without sphincterotomy, no difference was seen in rates of pancreatitis (1.54% vs 2.07%, P > 0.9999). Conclusion Single bile duct stents, both plastic and metal, can be deployed without EBS .