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Endoscopy 2014; 46(03): 252-255
DOI: 10.1055/s-0033-1359214
Case report/series
© Georg Thieme Verlag KG Stuttgart · New York

Multicenter experience with performance of ERCP in patients with an indwelling duodenal stent

Mouen A. Khashab
1   Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
,
Ali Kord Valeshabad
1   Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
,
Wesley Leung
2   Department of Medicine and Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
,
Joel Camilo
3   Division of Gastroenterology and Hepatology, University of Colorado, School of Medicine, Aurora, Colorado, USA
,
Norio Fukami
3   Division of Gastroenterology and Hepatology, University of Colorado, School of Medicine, Aurora, Colorado, USA
,
Frederick Shieh
4   Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania, USA
,
David Diehl
4   Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania, USA
,
Rajeev Attam
5   Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
,
Frank P. Vleggaar
6   Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
,
Payal Saxena
1   Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
,
Martin Freeman
5   Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
,
Anthony Kalloo
1   Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
,
Peter D. Siersema
6   Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
,
Stuart Sherman
2   Department of Medicine and Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
› Author Affiliations
Further Information

Publication History

submitted 21 July 2013

accepted after revision 29 October 2013

Publication Date:
05 February 2014 (online)

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Endoscopic retrograde cholangiopancreatography (ERCP) in patients with a preexisting duodenal stent covering the papilla is particularly challenging. The aim of this study was to describe a multicenter experience of performing ERCP in patients with biliary obstruction in whom the papilla was obscured by a preexisting duodenal stent. A total of 38 patients with preexisting duodenal stents obscuring the papilla underwent ERCP. Endoscopic biliary cannulation was successful in 13 patients (34.2 %). In 12 of these 13 patients (92.3 %), endoscopic therapy was performed during the same procedure and achieved clinical success with relief of jaundice in all cases (100 %). The most commonly utilized procedure in patients in whom ERCP failed was EUS-guided biliary drainage (EGBD; n = 13 /22, 59.1 %), followed by percutaneous transhepatic biliary drainage (n = 9 /22, 40.9 %). Three patients in whom ERCP failed either did not consent to further intervention or were transferred to other centers. Thus, ERCP was technically challenging in our cohort of patients with preexisting duodenal stents, but was nonetheless successful in about one third of cases. Overall, when performed by experts, endoscopic biliary drainage (via ERCP or EGBD) can be successfully achieved in the majority of patients with indwelling duodenal stents.

 

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