Open AccessRadiation-Free Transabdominal Ultrasound-Guided Endoscopic Biliary Stenting in Pregnant Women with Choledocholithiasis
Author(s) -
Mohammed Mahmoud Abdo,
Mohammad al-Shatouri
Publication year - 2021
Publication title -
iranian journal of radiology./iranian journal of radiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.12
H-Index - 14
eISSN - 2008-2711
pISSN - 1735-1065
DOI - 10.5812/iranjradiol.114097
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , fluoroscopy , common bile duct , radiology , endoscopy , surgery , pancreatitis , gestational age , pregnancy , genetics , biology
Background: Hepatobiliary disorders are common problems during pregnancy, causing significant morbidity and mortality in both mother and fetus. Biliary pancreatitis and cholangitis are common sequelae that warrant urgent endoscopic interventions. However, fetal radiation exposure is a major concern during endoscopic retrograde cholangiopancreatography (ERCP). Fetal malformation, preterm labor, and intrauterine fetal death are the recognized complications of ERCP. Objectives: To evaluate the application of transabdominal ultrasound (US) guidance in endoscopic biliary stenting as a substitute for fluoroscopy and contrast injection. Patients and Methods: In this study, we reviewed the data of ten pregnant patients, who had undergone endoscopic biliary stenting under US guidance without fluoroscopy between January 2018 and October 2020. An abdominal US examination was performed to confirm that the guide wire and the stent were placed inside the common bile duct (CBD) without fluoroscopy. The CBD clearance was postponed until after delivery. Results: The mean gestational age was 12 weeks (range: 5 - 33 weeks), and the mean maternal age was 23 years (range: 19 - 33 years). All procedures were performed successfully, with biochemical and clinical improvements after endoscopy. In none of the patients, maternal or fetal complications were reported after endoscopy or at birth. Also, no cases of post-endoscopic pancreatitis were documented. Conclusion: Based on the present findings, abdominal US guidance in endoscopic biliary stenting can be a safe and effective approach.