Department of Surgical Gastroenterology, King George's Medical University, Lucknow, UP, India.
Surg Endosc. 2018 Jan;32(1):191-195. doi: 10.1007/s00464-017-5657-z. Epub 2017 Jun 22.
Endoscopic biliary stenting is a common procedure in routine gastroenterology practice. Plastic stents are the most common type of stents used and are indicated mainly for short-term biliary drainage. Prolonged indwelling plastic stents can result in disastrous complications.
We conducted a retrospective analysis of patients who presented with complications of forgotten biliary stents in a tertiary care hospital during January 2010 to October 2016. All patients were managed either by endoscopic or surgical means. Details of these patients were obtained from departmental patient database, endoscopy records, and surgical register.
A total of 21 cases of retained biliary stents were managed in the study period and their outcome was analyzed. The median age was 47 years (range 17-70 years) and 17 (80.9%) patients were female. Primary indication of biliary stenting was stone disease in 76.2% (n = 16), while benign biliary stricture accounted for 19% of cases (n = 4). Mean duration at presentation to hospital after ERCP stenting was 3.53 years (range 1-14 years), with cholangitis being the most common presentation (66.67%). Definitive endoscopic treatment for forgotten stent and its associated complication was possible only in five patients (23.8%); in remaining 16 (76.2%) cases, surgical exploration was required. Despite life-threatening complications and major surgical interventions, no mortality was recorded.
Instances of forgotten biliary stents presenting with serious complications are not uncommon in Indian setup. Patients either ignore advice for timely stent removal or are unaware of the presence of endoprosthesis or need for removal. Adequate patient counseling, information, and proper documentation are essential to avoid this condition.
内镜下胆道支架置入术是常规胃肠病学实践中的常见操作。塑料支架是最常用的支架类型，主要用于短期胆道引流。留置时间过长的塑料支架可能导致灾难性的并发症。
我们对 2010 年 1 月至 2016 年 10 月期间在一家三级保健医院因遗忘性胆道支架引起并发症的患者进行了回顾性分析。所有患者均通过内镜或手术方式进行治疗。从科室患者数据库、内镜记录和手术登记册中获取这些患者的详细信息。
在研究期间共处理了 21 例保留的胆道支架，分析了其结果。中位年龄为 47 岁（范围 17-70 岁），17 例（80.9%）为女性。胆道支架置入的主要指征是结石疾病，占 76.2%（n=16），良性胆道狭窄占 19%（n=4）。ERCP 支架置入后到医院就诊的平均时间为 3.53 年（范围 1-14 年），最常见的表现是胆管炎（66.67%）。仅有 5 例（23.8%）患者可通过明确的内镜治疗来处理遗忘性支架及其相关并发症，在其余 16 例（76.2%）患者中需要进行手术探查。尽管存在危及生命的并发症和重大手术干预，但没有记录到死亡。
在印度，因严重并发症而出现的遗忘性胆道支架并不少见。患者要么忽略了及时取出支架的建议，要么不知道存在内支架或需要取出。充分的患者咨询、信息和适当的记录对于避免这种情况至关重要。
