Endoscopy 2020; 52(S 01): S261-S262
DOI: 10.1055/s-0040-1704820
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Clinical endoscopic practice ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

BILIARY DUCT STENTING AND STENT PATENCY: WHO, HOW LONG, WHY?

E Dieninytė-Misiūnė
1   Vilnius University, Faculty of Medicine, Vilnius, Lithuania
2   Vilnius University Hospital Santara Clinics, Vilnius, Lithuania
,
J Valantinas
1   Vilnius University, Faculty of Medicine, Vilnius, Lithuania
2   Vilnius University Hospital Santara Clinics, Vilnius, Lithuania
,
J Stanaitis
2   Vilnius University Hospital Santara Clinics, Vilnius, Lithuania
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Publikationsverlauf

Publikationsdatum:
23. April 2020 (online)

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    Aims Endoscopic stenting is a foremost therapy in biliary duct strictures with stent occlusion and cholangitis being the most prevalent complications. Since risk factors for stent occlusion are still unknown, we aimed at evaluating effect of stricture etiology on stent patency.

    Methods We conducted a retrospective study of patients who underwent endoscopic biliary duct stenting in a tertiary center in 2016–2017. We collected demographic (age, gender) and clinical data (etiology of biliary duct stricture, presence of cholangitis, bile duct and gallbladder stones, cholecystectomy, antibiotics, number and diameter of stents placed, days to the next stenting and whether the subsequent stent placement was emergent) from hospital records.

    Results Our study comprised 626 (re)stenting episodes with an intent for stent replacement after 3 months. 54,3% of patients were male, average age 63,9 ± 15,6 years. Stentings were grouped according to biliary duct stricture etiology: 22% were due to cholangiocarcinoma, 36,6% – extraductal malignancy, 11,4 – echinococcosis, and 30% due to other reasons. On average stent was patent for 62 days and 44,4% of following stent placements were emergent. ANOVA revealed significant effect of etiological group on time interval to next stenting (F(3, 622) = 39,5, p < 0,001). Logistic regression showed that biliary duct stones and cumulative stent diameter had protective effect from stenting being emergent, OR = 0,53, CI 0,34–0,83, p = 0,006 and OR = 0,86, CI 0,78–0,94, p = 0,002 respectively, whereas stent count increased the risk OR = 3,71, CI 1,70–8,08, p = 0,001. Cox regression revealed that cholangiocarcinoma and extraductal malignancy increased likelihood of stent replacement HR = 1,72, CI 1,38–2,15, p < 0,001 and HR = 1,8, CI 1,51–2,23, p < 0,001 correspondingly, whereas echinococcosis prolonged stent patency HR = 0,6, CI 0,46–0,81, p < 0,001.

    Conclusions Etiology of biliary duct stricture is evidently important in stent patency, echinococcosis being a prolonging factor. Further bile studies are warranted to investigate echinococcosis role in stent occlusion.


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