title: Use of a partially covered self-expandable metallic stent to treat a biliary stricture secondary to chronic pancreatitis complicated by recurrent cholangitis: a case report.
abstract: The patient was a 69 year old man who had been diagnosed with alcoholic chronic pancreatitis and lower common bile duct (CBD) stricture. He subsequently developed cholangitis 2-3 times a year, and we replaced the endoscopic biliary stent (EBS) each time. In April 2010, he was admitted because of complication by a liver abscess and acute cholangitis. We performed percutaneous transhepatic liver abscess drainage. The inflammatory findings then rapidly improved, but the patient developed acute cholangitis due to the sludge and the stones. Then, we placed a partially covered self-expandable metallic stent (C-SEMS) in the lower CBD and performed endoscopic lithotripsy through the C-SEMS, and the cholangitis subsequently improved. Two weeks after, we removed the C-SEMS endoscopically and replaced it with a 10 Fr plastic stent; since then there have been no recurrences of cholangitis. Our experience in this case suggested that when a plastic stent is placed long-term to treat a biliary stricture associated with chronic pancreatitis, it might be useful to also control biliary sludge and stones using a C-SEMS.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan. okabe_yoshinobu@kurume-u.ac.jp
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Okabe
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ishida
authors.forename: Yu
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ushijima
authors.forename: Gen
authors.initials: G
authors.lastname: Sugiyama
authors.forename: Osamu
authors.initials: O
authors.lastname: Tsuruta
mesh_terms: D000368:Aged; D002761:Cholangitis / Q000150:complications*; D003135:Common Bile Duct / Q000473:pathology*; D003137:Common Bile Duct Diseases / Q000628:therapy*; D003251:Constriction, Pathologic; D042882:Gallstones / Q000150:complications / Q000601:surgery; D006801:Humans; D008096:Lithotripsy; D008100:Liver Abscess / Q000150:complications; D008297:Male; D008670:Metals; D019512:Pancreatitis, Alcoholic / Q000150:complications*; D011474:Prosthesis Design; D012008:Recurrence; D015607:Stents; D014057:Tomography, X-Ray Computed
chemical_list: D008670:Metals