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Endoscopic stenting is a medical procedure by which a stent, a hollow device designed to prevent constriction or collapse of a tubular organ, is inserted by endoscopy. They are usually inserted when a disease process has led to narrowing or obstruction of the organ in question, such as the esophagus or the colon .
The black solid structure is the endoscope used to place the stent. Self-expandable metallic stents are typically inserted at the time of endoscopy, usually with assistance with fluoroscopy or x-ray images taken to guide placement. Prior to the development of SEMS small enough to pass through the channel of the endoscopy, SEMS were deployed ...
A relatively new and less-invasive method involving endoscopic ultrasound (EUS) guidance and fluoroscopy. A large bore needle is used to access the identified pseudocyst, creating a fistula between the cystic cavity and either the stomach or the duodenum. [6] Plastic stents may be placed to facilitate drainage from the pseudocyst. [4]
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.
The placement of a colon stent involves endoscopic techniques similar to esophageal stenting. A thin tube called an endoscope is inserted into the rectum and guided through the colon to locate the blockage. Using fluoroscopy or endoscopic guidance, a guidewire is passed through the narrowed area and then removed after positioning it properly.
Biliary endoscopic sphincterotomy is sometimes used, with or without stenting, to relieve the obstruction, but systematic reviews have not demonstrated consistent benefits. [ 5 ] Treatment of sphincter of Oddi dysfunction: this is a diagnosis of exclusion which encompasses a broad spectrum of hepatobiliary disorders including spasms, strictures ...
Some uses for this procedure includes: drainage of bile/infected bile to relieve obstructive jaundice, to place a stent to dilate a stricture in the biliary system, stone removal, and rendezvous technique [4] where guidewire from the common bile duct (CBD) meets with duodenoscope (coming from the oesophagus into the stomach and then duodenum) at the major duodenal papilla.