Bridging across the ampulla with metal stents: evidences for intestinal bile reflux.
OBJECTIVE
To investigate the early intestinal bile reflux following the implantation of metal stent across the ampulla and the mechanism of reflux cholangitis.


METHODS
Twenty-three patients with implantation of metal stent across the ampulla were recruited. Prior to the implantation, the white blood cell count, neutrophil percentage, total blood bilirubin, direct bilirubin and the trypsin content in the bile were recorded; 2-5 days after implantation these indices were measured again, as well as the 99mTc -DTPA radioactivity.


RESULTS
A high percentage (82.61%) of patients showed 99mTc in the bile in 2 hours, which accounts for 1.73% of total intake. In 4 cases the radioactivity was not found. Bile lipase and amylase levels were significantly higher than that in prior to the stent implantation. There were no changes in the white blood cell count and neutrophil percentage after stent implantation. Additionally, the total blood bilirubin and direct bilirubin decreased.


CONCLUSIONS
After the implantation of metal stent across the ampulla, there is evidence for the early intestinal bile reflux, without signs for the reflux cholangitis.
Feng
F
Wen
Zaiming
Z
Lu
Xiaonan
X
Mao
Hongyuan
H
Liang
Qiyong
Q
Guo
D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000000981:diagnostic imaging / Q000378:metabolism; D001646:Bile / Q000000981:diagnostic imaging / Q000378:metabolism; D001655:Bile Reflux / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D001663:Bilirubin / Q000097:blood; D002761:Cholangitis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D002779:Cholestasis / Q000175:diagnosis / Q000628:therapy*; D004322:Drainage / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015607:Stents; D016284:Technetium Tc 99m Pentetate; D013997:Time Factors; D016896:Treatment Outcome; D014357:Trypsin / Q000378:metabolism
D008670:Metals; D019275:Radiopharmaceuticals; D014357:Trypsin; D001663:Bilirubin; D016284:Technetium Tc 99m Pentetate