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Hypaque or other water-soluble dye may be placed through the passage to ensure patency of the stent on fluoroscopy. [15] Enteric and colonic SEMS are inserted in a similar fashion, but in the duodenum and colon respectively. [16] Biliary SEMS are used to palliatively treat tumours of the pancreas or bile duct that obstruct the common bile duct.
Stents with anchoring flaps or flared ends can reduce the risk of migration. Cholecystitis can be a complication for stenting of malignant biliary stricture. Stent occlusion may occur from tumor or tissue overgrowth, or due to sludge deposits, causing the development of cholangitis. [1]
Pancreatic and biliary stents provide pancreatic and bile drainage from the gallbladder, pancreas, and bile ducts to the duodenum in conditions such as ascending cholangitis due to obstructing gallstones. Pancreatic and biliary stents can also be used to treat biliary/pancreatic leaks or to prevent post-ERCP pancreatitis. [12]
These strictures can cause cholestasis which can lead to jaundice, pruritus, cholangitis, and gallstone formation. Biliary endoscopic sphincterotomy is sometimes used, with or without stenting, to relieve the obstruction, but systematic reviews have not demonstrated consistent benefits. [5]
Other procedures associated with ERCP include the trawling of the common bile duct with a basket or balloon to remove gallstones and the insertion of a plastic stent to assist the drainage of bile. [11] Also, the pancreatic duct can be cannulated and stents be inserted. The pancreatic duct requires visualisation in cases of pancreatitis.
Cholecystostomy or (cholecystotomy) is a medical procedure used to drain the gallbladder through either a percutaneous or endoscopic approach. The procedure involves creating a stoma in the gallbladder, which can facilitate placement of a tube or stent for drainage, first performed by American surgeon, Dr. John Stough Bobbs, in 1867.
Anastomotic stricture can lead to cholangitis, or inflammation of the bile duct. [1] Narrowing of the bile duct leads to a buildup of pressure, causing the intercellular gaps to widen, exposing the cells to microorganisms found within the bile, resulting in inflammation. [18] Symptoms include jaundice and pain in the upper right quadrant.
Biliary drainage is performed with a tube or catheter (called a biliary drain, biliary stent or biliary catheter) by a surgeon or, commonly, an interventional radiologist. [3] It can be used to relieve a blockage in the bile duct, either permanently or as a temporary solution before definite treatment such as surgery.