title: Oldest biliary endoprosthesis in situ.
abstract: The advantages of endoscopic retrograde cholangiopancreatography over open surgery have made it the predominant method of treating patients with choledocholithiasis. After sphincterotomy, however, 10%-15% of common bile duct stones cannot be removed with a basket or balloon. The methods for managing "irretrievable stones" include surgery, mechanical lithotripsy, intraductal or extracorporeal shock wave lithotripsy and biliary stenting. The case presented was a referred 82-year-old Caucasian woman with a 7-year-old plastic biliary endoprosthesis in situ. To the best of our knowledge the examined endoprosthesis is the oldest endoprosthesis in situ reported in the literature. Endoscopic biliary endoprosthesis placement remains a simple and safe procedure for patients with stones that are difficult to manage by conventional endoscopic methods and for patients who are unfit for surgery or who are high surgical risks. To date no consensus has been reached regarding how long a biliary prosthesis should remain in situ. Long-term biliary stenting may have a role in selected elderly patients if stones extraction has failed because the procedure may prevent stones impaction and cholangitis.
authors.affiliation: Pierluigi Consolo, Giuseppe Scalisi, Stefano F Crinò, Andrea Tortora, Giuseppa Giacobbe, Marcello Cintolo, Luigi Familiari, Socrate Pallio, Digestive Endoscopy Unit, University Hospital, 98100 Messina, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Consolo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Scalisi
authors.forename: Stefano F
authors.initials: SF
authors.lastname: Crinò
authors.forename: Andrea
authors.initials: A
authors.lastname: Tortora
authors.forename: Giuseppa
authors.initials: G
authors.lastname: Giacobbe
authors.forename: Marcello
authors.initials: M
authors.lastname: Cintolo
authors.forename: Luigi
authors.initials: L
authors.lastname: Familiari
authors.forename: Socrate
authors.initials: S
authors.lastname: Pallio
keywords: Biliary endoprosthesis; Cholangitis; Common bile duct stones; Endoscopic retrograde cholangiopancreatography; Endoscopic sphincterotomy