Expanding Use of Fully Covered Metallic Biliary Stents during Endoscopic Retrograde Cholangiopancreatography for Benign Biliary Disease
Hassaan Muhammad Yousuf, Jun Liong Chin, Karen Boland, Frank Murray, Stephen Patchett
Department of Gastroenterology, Beaumont Hospital, RCSI, Dublin 9.
Fully covered self-expanding metallic biliary stenting via endoscopic retrograde cholangiopancreatography (ERCP) is now increasingly used for benign and malignant biliary diseases. Although the cost of fully covered metallic biliary stents (FCMBS) is substantially higher compared to plastic stents, there are several advantages of FCMBS in benign biliary conditions including adequacy of biliary drainage, reduced number of procedures for stone extraction and stricture dilatation with subsequent removal of stent. In suspected malignant biliary or pancreatic disease, these FCMBS can also be removed if malignancy is not confirmed.
We plan to investigate the indications for fully covered self-expanding metallic biliary stent use during ERCP in a tertiary Dublin hospital.
Data of patients receiving biliary stents during ERCP were obtained from endoscopy database (Diver and Endoraad). Patients receiving uncovered metallic stents or plastic stents were excluded.
We retrospectively examined 65 patients who had ERCP and had fully covered metallic biliary stent inserted. In our study cohort of 65 patients, the median age was 73 (IQR 62-81) years with 61.5% (40/65) females. The majority of patients had fully covered metallic biliary stents inserted for benign biliary disease (69.2%, 45/65), while 30.8% (20/65) of patients were stented for suspected or confirmed malignant stricture. For patients receiving stent for benign disease, 84.4% (38/45) of patients had common bile duct stones; 6.7% (3/45) of patients had biliary leak after cholecystectomy; 4.4% (2/45) had benign biliary stricture; and 1 patient had Mirizzi's syndrome. The average duration for removal of FCMBS was 3.58 ±3.88 months.
Fully covered self-expanding metallic biliary stents are increasingly used to facilitate stone extraction of common bile duct stones.