Endoscopy 2018; 50(04): S45
DOI: 10.1055/s-0038-1637161
ESGE Days 2018 oral presentations
20.04.2018 – ERCP 2: bile duct stenosis
Georg Thieme Verlag KG Stuttgart · New York

RISK FACTORS FOR DUODENAL PERFORATION CAUSED BY BILIARY PLASTIC STENT MIGRATION

JK Ryu
1   Seoul National University, Seoul, Korea, Republic of
,
JY Cho
2   Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea, Republic of
,
YT Kim
1   Seoul National University, Seoul, Korea, Republic of
,
YB Yoon
1   Seoul National University, Seoul, Korea, Republic of
,
WH Paik
3   Seoul National University, Internal Medicine, Seoul, Korea, Republic of
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
27. März 2018 (online)

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Aims:

Migration of biliary plastic stent (PS) inserted by endoscopic retrograde cholangio- pancreatography can cause duodenal perforation and become a life-threatening condition, yet there is no study revealing its risk factors. We aim to report the incidence of duodenal perforation caused by biliary plastic stent migration and seek the risk factors.

Methods:

All patients who received endoscopic retrograde cholangiopancreatography with a biliary plastic stent placement at our institution during January 2006 to August 2016 were reviewed. The etiology of disease, diameter, length, type of the PS and time to perforation was reviewed.

Results:

A total of 6,371 endoscopic biliary drainage was done and 4,111 with PSs, and 2,994 with straight PS including 713 Tannenbaum stents. Eight patients with duodenal perforation caused by biliary PS were identified and all of the cases had at least one straight PS inserted. Duodenal perforation occurred in 0.27% of straight PS cases. All of these cases had at least 12 cm long straight PS inserted. Two of them had benign stricture and six of them had malignant stricture. Time to perforation ranged between 2 to 84 days. Straight PSs 12 cm (p= 0.001) or longer and malignant etiology (p= 0.010) were the risk factors of duodenal perforation caused by biliary PS migration.

Conclusions:

The incidence of duodenal perforation caused by biliary PS migration is about 0.27% of straight PS cases. Straight PS at least 12 cm long and malignant etiology were the risk factors of duodenal perforation caused by PS migration.