scholarly journals Endoscopic transpapillary gallbladder stenting to prevent acute cholecystitis in patients receiving FCEMS for benign biliary stricture

2021 ◽  
Vol 09 (09) ◽  
pp. E1386-E1390
Author(s):  
Morgan Wong ◽  
Sergio A. Sánchez-Luna ◽  
Tarun Rustagi
Keyword(s):  
Acute Cholecystitis ◽  
Total Bilirubin ◽  
Biliary Stricture ◽  
Total Bilirubin Level ◽  
Metal Stents ◽  
Benign Biliary Strictures ◽  
Procedural Complications ◽  
Successful Removal ◽  
Self Expanding Metal Stents

Abstract Background and study aims Fully covered self-expanding metal stents (FCSEMS) are being increasingly used for benign biliary strictures (BBS); however, they are associated with risk of acute cholecystitis. Prophylactic endoscopic transpapillary gallbladder stenting (ETPGBS) can facilitate continuous gallbladder drainage and prevent acute cholecystitis from occlusion of cystic duct orifice by the FCSEMS. The aim of this study was to assess the technical feasibility, efficacy, and safety of ETPGBS to prevent acute cholecystitis in patients receiving FCSEMS for BBS. Patients and methods This was a retrospective analysis of a prospectively collected database at a single center of all patients who underwent prophylactic ETPGBS with FCSEMS for BBS between December 1, 2016 and November 30, 2020. Results A total of 71 ETPGBS were placed during the study period. Sixteen patients (mean age: 66.4 ± 19.8 years; 81 % male) underwent ETPGBS prior to biliary FCSEMS during the same endoscopic session. FCSEMS were left in place (stent dwell time) for a median of 173 days (range: 69–473; mean 196 ± 121) with resolution of BBS and successful removal of ETPGBS and FCSEMS in 12 patients. There was significant improvement in total bilirubin level (5.25 ± 5.53 vs 0.94 ± 0.85 gm/dL; P = 0.008). No episodes of acute cholecystitis or any other post-procedural complications were noted during the median follow-up of 337 days (range: 150–856; mean 394 ± 236). Conclusions ETPGBS prevented stent-related acute cholecystitis with continued efficacy of FCSEMS for BBS.

Self-Expanding Metal Stents in Benign Biliary Strictures Due to Chronic Pancreatitis

Endoscopy ◽  
2004 ◽  
Vol 36 (05) ◽  
pp. 381-384 ◽  
Author(s):  
A. van Berkel ◽  
D. Cahen ◽  
D. van Westerloo ◽  
E. Rauws ◽  
K. Huibregtse ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Metal Stents ◽  
Biliary Strictures ◽  
Benign Biliary Strictures ◽  
Self Expanding Metal Stents

scholarly journals Effect of covered self-expanding metal stents compared with multiple plastic stents on benign biliary stricture

Medicine ◽  
2018 ◽  
Vol 97 (36) ◽  
pp. e12039 ◽  
Author(s):  
Xinjing Zhang ◽  
Xuedong Wang ◽  
Liang Wang ◽  
Rui Tang ◽  
Jiahong Dong
Keyword(s):  
Biliary Stricture ◽  
Plastic Stents ◽  
Metal Stents ◽  
Benign Biliary Stricture ◽  
Self Expanding Metal Stents

scholarly journals Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a silicone-covered nitinol short bilaterally flared stent: a case series

2017 ◽  
Vol 05 (11) ◽  
pp. E1111-E1116 ◽  
Author(s):  
Raffaele Manta ◽  
Claudio Zulli ◽  
Angelo Zullo ◽  
Edoardo Forti ◽  
Alberto Tringali ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Endoscopic Ultrasound ◽  
Clinical Success ◽  
Symptom Relief ◽  
Case Series ◽  
Metal Stents ◽  
Success Rates ◽  
Gallbladder Drainage ◽  
First Case

Abstract Background and study aim Gallbladder drainage in patients with cholecystitis who are unsuitable for surgery may be performed by endoscopic ultrasound (EUS)-guided placement of specifically designed fully covered metal stents. We describe the first case series of patients treated with a silicone-covered nitinol stent with bilateral anchor flanges. Patients and methods Data from consecutive patients with acute cholecystitis who were deemed unsuitable candidates for surgery were collected. The stent placement procedure was performed in two tertiary endoscopy centers by four experienced endoscopists. Technical and clinical success rates, as well as adverse events and clinical outcome at follow-up, were assessed. Results EUS-guided drainage for cholecystitis was performed in 16 patients (mean age 84 years; nine males). Technical and clinical success rates were 100 % (16/16) and 94 % (15/16), respectively; an early failure due to stone impaction occurred in the remaining case and required placement of a new stent. Symptom relief occurred in 11/15 cases (73 %) within 1 day, and within 2 days in the remaining 4 patients. Bleeding occurred in two patients (13 %): in one patient intraprocedural bleeding was successfully stopped during endoscopy; and delayed bleeding occurred in one patient requiring arterial embolization for catastrophic bleeding (patient died 10 days later). No cases of cholecystitis recurrence or biliary obstruction were observed during a median follow-up of 112 days (range 49 – 180 days). Conclusions Our data showed that EUS-guided gallbladder drainage with a specially designed stent is feasible and successful in patients with acute cholecystitis who are unfit for surgery.

A 5-year follow-up of self-expanding metal stents in the endoscopie management of patients with benign bile duct strictures

1998 ◽  
Vol 10 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Sharon M. OʼBrien ◽  
Adrian R.W. Hatfield ◽  
Philip I. Craig ◽  
Steven P. Williams
Keyword(s):  
Bile Duct ◽  
Metal Stents ◽  
Self Expanding Metal Stents

scholarly journals Risk Factors for Prognosis after the Maze IV Procedure in Patients with Atrial Fibrillation Undergoing Valve Surgery

2021 ◽  
Author(s):  
Shenghua Zhou
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Bilirubin Level ◽  
Right Atrium ◽  
Total Bilirubin ◽  
Elevated Serum ◽  
Total Bilirubin Level ◽  
Valve Surgery ◽  
Serum Total Bilirubin

The present study evaluated risk factors related to persistent atrial fibrillation (AF) at discharge (AF-d) and recurrentatrial fibrillation (rAF) and all-cause death after the maze IV procedure. Two hundred nineteen patients (63 female,aged 52.5 ± 8.8 years) with valve disease and persistent AF undergoing valve surgery and the maze IV procedure in our center between 2015 and 2016 were included. Baseline demographic and clinical data were obtained by review of medical records. The median follow-up period was 27 months (interquartile range 21–34 months) in our patient cohort.The primary end point was all-cause death. The secondary end point was AF-d or rAF. rAF is defined as AF recurrenceat 3 months or later after the procedure. Twenty-eight patients (12.8%) died during follow-up. Multiple logistic regression analysis showed that thrombocytopenia, elevated serum total bilirubin level, a larger right atrium, AF-d, and rAF were independent determinants for all-cause death after the maze IV procedure after adjustment for age, sex, and clinical covariates, including New York Heart Association class III/IV disease, hypertension, and aortic regurgitation, while valvular disease duration and left atrial diameter greater than 80.5 mm were independent determinants for AF-d, and thrombocytopenia, elevated serum total bilirubin level, higher mean pulmonary artery pressure, and AF-d were independent predictors for rAF. In conclusion, thrombocytopenia, elevated serum total bilirubin level, an enlarged right atrium, AF-d, and rAF are independent predictors of all-cause death in patients undergoing the maze IV procedure.

Multicenter Trial Evaluating the Use of Covered Self-expanding Metal Stents in Benign Biliary Strictures

2013 ◽  
Vol 47 (8) ◽  
pp. 695-699 ◽  
Author(s):  
Michel Kahaleh ◽  
Alan Brijbassie ◽  
Amrita Sethi ◽  
Marisa DeGaetani ◽  
John M. Poneros ◽  
...  
Keyword(s):  
Multicenter Trial ◽  
Metal Stents ◽  
Biliary Strictures ◽  
Benign Biliary Strictures ◽  
Self Expanding Metal Stents
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