Bridging of benign choledochal stenoses by endoscopic retrograde implantation of mesh stents.
A prospective study of a new stent for bridging choledochal stenoses was performed in seven patients (5 females, 2 males, age range 49-80 years) with benign bile duct stenosis or bilioduodenal fistula in whom conventional bougienage (3 patients) and/or month-long implantation of plastic prostheses (7 patients) failed because of reocclusion. The self-expanding mesh stents (Wallstent) were implanted by duodenoscopy in six patients. In one patient with a B-II stomach, the stent could only be inserted by the percutaneous transhepatic route. All prostheses were inserted endoscopically without complications. At follow-up after an average of eight months prosthesis-related complications were found in only one patient; there was no case of prosthesis occlusion. One patient with a bilioduodenal fistula of unknown origin developed fever and sepsis three days after implantation and subsequently a liver abscess which resolved on repeated drainage and antibiotic therapy. Although definitive interpretation of the results requires a longer follow-up period, on the basis of the present data endoscopic reconstructive splinting of benign choledochal stenosis would appear to be a promising technique.
Foerster
E C
EC
Medizinische Klinik und Poliklinik B, Universität Münster, Germany.
Hoepffner
N
N
Domschke
W
W
D000368:Aged; D000369:Aged, 80 and over; D003135:Common Bile Duct / Q000473:pathology*; D003251:Constriction, Pathologic / Q000628:therapy; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents; D013526:Surgical Mesh