Why do bilioduodenal plastic stents become occluded? A clinical and pathological investigation on 100 consecutive patients.
OBJECTIVE
The main complication associated with biliary stenting is stent occlusion. This study tested the hypothesis that bilioduodenal reflux may play a crucial role in stent clogging.


METHODS
Plastic stents in 100 consecutive patients with various biliary disorders were investigated macroscopically and cytologically.


RESULTS
In 37 patients with elective stent extraction, the only risk factor for stent occlusion was the duration of stenting. Plant material was found as a consequence of duodenobiliary reflux in 38 of the 89 stents with any stent content. In patients who had two stents, the stent content was identical in eight of 14 cases.


CONCLUSIONS
In addition to other mechanisms of biliary stent occlusion, duodenobiliary reflux appears to play an important role. A stent design capable of at least partly preventing this type of reflux might be of clinical benefit.
Weickert
U
U
Dept. of Medicine II (Gastroenterology), Wuppertal Clinical Center, University of Witten/Herdecke, Germany. uwe.weickert@cityweb.de
Venzke
T
T
König
J
J
Janssen
J
J
Remberger
K
K
Greiner
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000601:surgery*; D001655:Bile Reflux / Q000209:etiology*; D002779:Cholestasis / Q000209:etiology*; D004380:Duodenal Obstruction / Q000209:etiology*; D004383:Duodenogastric Reflux / Q000209:etiology*; D004386:Duodenum / Q000601:surgery*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010969:Plastics / Q000009:adverse effects*; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*
D010969:Plastics