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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]
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]
These complications may be limited by the use of coated stents. [6] [19] Tumour ingrowth or overgrowth can be additionally palliated by the placement of a second stent through the lumen of the first, [6] through electrocautery or argon plasma coagulation of the tumour tissue in the stent, [6] or through the use of photodynamic therapy. [20]
However, the stent has not completely done away with restenosis after angioplasty, and improved procedures continue to be sought. The drug-eluting stent, which releases chemicals that inhibit restenosis, has shown marked success and seems to be replacing the bare-metal stent in America, though Europeans have resisted the change due to the expense.
A bare-metal stent is a stent made of thin, uncoated (bare) metal wire that has been formed into a mesh-like tube. The first stents licensed for use in cardiac arteries were bare metal – often 316L stainless steel. More recent "second generation" bare-metal stents have been made of cobalt chromium alloy. [1]
It can be sent for a bilirubin and alkaline phosphatase test if there are concerns regarding the output. [5] After the surgery, nasogastric suction is usually maintained for 2–3 days and the tube is removed when there is low output. Once the tube is in place, it can be used to give the patient food and medicine.
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.
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.
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