Endoscopy 2020; 52(S 01): S299
DOI: 10.1055/s-0040-1704952
ESGE Days 2020 ePoster presentations
Colon and rectum 09:00–17:00 Thursday, April 23, 2020 ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

COVERED SELF-EXPANDABLE METAL STENTS FOR THE TREATMENT OF ERCP-RELATED PERFORATIONS: RESULTS FROM SINGLE CENTER EXPERIENCE FROM DISTRICT HOSPITAL IN JAPAN

H Hisai
1   Japanese Red Cross Date Hospital, Department of Gastroenterology, Date, Japan
,
T Sakurai
1   Japanese Red Cross Date Hospital, Department of Gastroenterology, Date, Japan
,
Y Koshiba
1   Japanese Red Cross Date Hospital, Department of Gastroenterology, Date, Japan
,
T Imagawa
1   Japanese Red Cross Date Hospital, Department of Gastroenterology, Date, Japan
,
K Ono
1   Japanese Red Cross Date Hospital, Department of Gastroenterology, Date, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims Perforation is one of the most feared complications of ERCP. The treatments for ERCP-related perforation are diverse, depending on the location and mechanism of the perforation and the time of diagnosis. Covered self-expandable metal stents (CSEMS) has become a therapeutic option to seal perforation and prevent entry into the perforation site. The purpose of this study was to assess the safety and efficacy of CSEMS for the treatment of ERCP-related perforations.

    Methods Between November 2011 and April 2019, consecutive 8 patients (2 men, 6 women, mean age 75.5 years, range, 67 – 87 years) who underwent CSEMS placement for ERCP-related perforations were enrolled in this study. We used 8–12 mm in diameter, 6 cm long, CSEMS (fully CSEMS in 7 patients and partially CSEMS in 1). We reviewed endoscopic and medical records of these patients to collect the following data: patients demographics, indications for ERCP, causes and sites of perforation, CSEMS removal, treatment outcomes and adverse events.

    Results Indications for initial ERCP were choledocholithiasis in 6 patients and malignant biliary strictures due to pancreatic cancer in 2. Causes of perforation were endoscopic sphincterotomy in 5 and one case each of needle knife papillotomy, catheter and guidewire. Perforation sites were perivaterian in 7 and common bile duct in 1. In all patients except one, perforation was recognized during or immediately after the procedure. After placement, there were no need for surgery and median time to post-operative feeding was 6 (1–13) days. CSEMS were removed in 6 patients with choledocholithiasis after a median time of 16 (10–61) days with grasping forceps or polypectomy snare without any complications. Adverse events related to CSEMSs placement were cholangitis in 1 and inward migration in 1. There were no procedure-related deaths.

    Conclusions CSEMS placement is effective in patients with ERCP-related perforations. However, attention should be paid to the procedure-related complications.


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