scholarly journals Authors� response to �Straight plastic stents in tumours at the hepatic hilum and related duodenal perforation�

2020 ◽  
Author(s):  
Iñigo Roa Esparza ◽  
Irene Arteagoitia Casero ◽  
Ángel Barturen Barroso
Keyword(s):  
Plastic Stents ◽  
Duodenal Perforation ◽  
Hepatic Hilum

scholarly journals Complications due to Biliary Stent Deviation

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Kinoshita Kumar ◽  
◽  
Fukuchi S ◽  
Murakami K ◽  
◽  
...  
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sphincterotomy ◽  
Clinical Symptoms ◽  
Acute Cholangitis ◽  
Biliary Stent ◽  
Plastic Stents ◽  
Duodenal Perforation ◽  
Early Complications ◽  
Biliary Stents ◽  
Uterine Appendage

We often encounter complications from biliary stents used as a treatment for obstructive jaundice and acute cholangitis. Early complications after stent placement include pancreatitis, bleeding, and duodenal perforation [1]. Stent deviation is also a complication. This is particularly prominent for plastic stents, where stent deviation is observed in 6-18.7 % of cases [2]. Stent deviation is more common among patients who have undergone endoscopic sphincterotomy (Figure 1). Most deviated biliary plastic stents are excreted in stool or collected endoscopically, but, very rarely, complications causing gastrointestinal perforation have been reported. We have described deviated biliary plastic stents causing sigmoid colon diverticulum perforation and even uterine appendage penetration (Figure 2). Diagnosis can be made from clinical symptoms and abdominal computed tomography. Treatment is basically surgery. Biliary stent-related complications are inevitable, and sometimes become serious. On suspicion of such complications, the most important issue is to accurately and rapidly diagnose complications and conduct appropriate management.

scholarly journals Tu1048 PREVALENCE AND RISK FACTORS FOR DUODENAL PERFORATION DUE TO MIGRATED BILIARY PLASTIC STENTS

2020 ◽  
Vol 91 (6) ◽  
pp. AB519-AB520
Author(s):  
Pauline M. Stassen ◽  
David de Jong ◽  
Jan-Werner Poley ◽  
Marco J. Bruno ◽  
PJF de Jonge
Keyword(s):  
Risk Factors ◽  
Plastic Stents ◽  
Duodenal Perforation

scholarly journals Endoscopic management of duodenal perforations caused by migrated biliary plastic stents

2019 ◽  
Vol 07 (06) ◽  
pp. E792-E795 ◽  
Author(s):  
Shin Hee Kim ◽  
Jong Ho Moon ◽  
Yun Nah Lee ◽  
Tae Hoon Lee ◽  
Sang Myung Woo ◽  
...  
Keyword(s):  
Stent Migration ◽  
Plastic Stents ◽  
Endoscopic Management ◽  
Duodenal Perforation ◽  
Mortality And Morbidity ◽  
Procedural Complication ◽  
Life Threatening ◽  
Stage Renal Disease ◽  
End Stage ◽  
Duodenal Perforations

Abstract Background and study aims Duodenal perforation by migration of plastic stents placed to treat biliary lesions is rare but can be life-threatening. Surgical management is preferred, but it may increase risks of mortality and morbidity, especially in patients with underlying comorbidities and those of advanced age. We describe five cases of duodenal perforation that were successfully managed endoscopically. Four patients were elderly, and one had end-stage renal disease. We used cylindrically adapted cap-fitted endoscopy to successfully retrieve migrated plastic stents and to close the perforated walls with hemoclips. No post-procedural complication was noted. In conclusion, endoscopic management is appropriate as a first-line approach in patients with duodenal perforations caused by plastic stent migration.

scholarly journals A rare complication of ERCP: duodenal perforation due to biliary stent migration

2020 ◽  
Vol 08 (11) ◽  
pp. E1530-E1536
Author(s):  
Mark A. Gromski ◽  
Benjamin L. Bick ◽  
David Vega ◽  
Jeffrey J. Easler ◽  
James L. Watkins ◽  
...  
Keyword(s):  
Biliary Stricture ◽  
Rare Complication ◽  
Stent Migration ◽  
Plastic Stents ◽  
Duodenal Wall ◽  
Duodenal Perforation ◽  
Biliary Stents ◽  
Endoscopic Retrograde ◽  
Factors Associated ◽  
Migration Event

Abstract Background and study aims Perforation of the duodenal wall opposing the major papilla due to a migrated pancreatobiliary stent rarely has been described in the literature as a complication of endoscopic retrograde cholangiopancreatography (ERCP). Factors associated with perforation from migrated stents from ERCP are unknown. Patients and methods This was a retrospective, observational study. Patients were identified from January 1, 1994 to May 31, 2019 in a prospectively maintained ERCP database. Results Eleven cases of duodenal perforation from migrated pancreatobiliary stents placed at ERCP were identified during the study period. All cases involved biliary stents, placed for biliary stricture management. The perforating stent was plastic in 10 cases (91 %). This complication occurred in one in 2,293 ERCP procedures in which a pancreatobiliary stent was placed. Conclusion This complication is more common with biliary stents compared to pancreatic stents. This may be related to the angle of exit of biliary stents being more perpendicular to the opposing duodenal wall and the near exclusive use of external pigtail plastic stents in the pancreatic duct. All perforating plastic stents were ≥ 9 cm in length. Longer stents may provide leverage for perforation with a migration event.

LAPAROSCOPIC REPAIR OF PERFORATED DUODENAL ULCER PATCH VERSUS CONVENTIONAL SURGERY

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Anil Kumar Saxena ◽  
Dr. Devi Das Verma
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Wound Dehiscence ◽  
Duodenal Perforation ◽  
Perforated Duodenal Ulcer ◽  
Conventional Surgery ◽  
Duodenal Ulcers ◽  
Duration Of Operation ◽  
Repair Group

Introduction: For many surgeries for duodenal ulcer Laparoscopic repair has become gold standard for many elective procedures such as ant reflux procedures, laparoscopic cholecystectomy and in colorectal surgery. Although in the emergency setting such as in the management of perforated duodenal ulcer Laparoscopic repair has been slow and limited. Since 1990, for the treatment of perforated peptic ulcer Laparoscopic repair has been used which has been widely accepted as an effective method. Duodenal ulcer is defined as a peptic ulcer which develops in the first part of the small intestine called duodenum and usually present as a perforation of acute abdomen. In perforated duodenal symptoms as severe and sudden onset abdominal pain that is worse in right upper quadrant and epigastrium and usually followed by nausea and vomiting. In this situation there is rapid generalization of pain and in examination shows peritonitis with lack of bowel sounds. Aim: The main objective of this study is to evaluate outcome of laparoscopic surgery in comparison with conventional surgery. Material and methods: All the patients with clinically diagnosed with perforated duodenal ulcers presenting within 24 hours of symptoms and undergoing surgery were included during the study period. Total 50 patients were included with age group 15-65 years. All the patients with perforated duodenal ulcers were included which go through either conventional open or laparoscopic without omental patch repair. Result: Total 50 patients were included in these studies which were divided into two group with 25 patients in each group as laparoscopic duodenal perforation repair group and conventional open repair group. Mean duration of operation (in minutes) was 105.4±10.4 in laparoscopic duodenal perforation repair group whereas mean duration of operation (in minutes) was 67.3±8.6 in conventional open repair group. Mean duration of number of doses of analgesics required in laparoscopic group and conventional open group as 9.5±1.7 and 17.2± 3.1 respectively. Out of 25 patients in each group of laparoscopic duodenal perforation repair group and the conventional open repair group the outcome were noted with their post operative complication as shown in table no 5 below.   In Post-operative complications 21(84%) patients in laparoscopic duodenal perforation repair group and 14(56%) patients in conventional open repair group had no complications. 4 (16%) patients in the laparoscopic duodenal perforation repair group and 2(8%) patients in conventional open repair group showed Post-operative complications as chest infection. In the conventional open repair group  patients present with wound dehiscence and wound infection and Wound dehiscence and chest infection were 4(16%) and 5(20%) respectively whereas nil in Laparoscopic duodenal perforation repair group. Conclusion: Duodenal ulcer perforation is a life-threatening emergency which required urgent management for the patients. Due to the advance in duodenal ulcer perforation closure by laparoscopy it becomes popular and favorite choice. With certain criteria, laparoscopic closure of perforated duodenal ulcer is safe and effective though it was associated with longer operating time and had no impact on the outcome. Hence laparoscopic closure was better in comparison to open repair for the earlier returns to normal daily activities. Keywords:  Duodenal ulcer, Laparoscopic repair, Post-operative analgesia, conventional surgery

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