Endoprótesis biliar en el manejo transitorio de la coledocolitiasis

• Mario Anselmi M ^[1] ; Juan Carlos Acuña C ^[1] ; Ana Del Valle M ^[2] ; Ana María Gemmato P ^[2]
  1. [1] Universidad de Concepción

     Universidad de Concepción

     Comuna de Concepción, Chile

     
  2. [2] Hospital Guillermo Grant Benavente Servicio de Cirugía Unidad de Cirugía Endoscópica
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 134, Nº. 6, 2006, págs. 721-725
• Idioma: español
• Títulos paralelos:
  • Endoscopic biliary stents for the temporary management of choledocholithiasis
• Enlaces
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• Resumen

  • Background: Endoscopic extraction of biliary tract stones is safe and effective. When the procedure is not successful, the use of a temporary stent can be a solution. Aim: To prospectively analyze the usefulness of endoscopic biliary stents in the temporary management of biliary obstruction due to choledocholithiasis. Material and methods: Analysis of 51 consecutive patients (age range 21-88 years, 34 females) with common bile duct stones that, from January 1999 to December 2001, were subjected to an endoscopic insertion of a biliary stent. Results: The indications for stent placement were a large stone in 40 patients (78%), the insecurity of a complete biliary tract cleaning in eight (16%) and technical difficulties in three (6%). Twenty seven patients (52.9%) were jaundiced and 17 (33.3%) had cholangitis. The prostheses remained in place until definitive resolution of the choledocholithiasis in 47 patients (92%) and migrated in 4 (8%). Bilirubin levels became normal in all cases with jaundice and infection resolved in all those with cholangitis. The definitive treatment of choledocholithiasis was done endoscopically in 28 patients (58%) and surgically in 20 (42%). Three patients were lost from follow up. Of these, one patient (2%) died 14 months later due to a recurrent cholangitis. The remaining two patients were asymptomatic and with the prostheses still in place 522 and 560 days post stent placement. Conclusions: When the immediate endoscopic resolution of choledocholithiasis is not possible, temporary stenting is a simple and safe therapeutic alternative that allows patients to be free of obstructive complications until the definitive treatment is carried out