Sbeit Wisam, Khoury Tawfik, Kadah Anas, M Livovsky Dan, Nubani Adi, Mari Amir, Goldin Eran, Mahamid Mahmud
Department of Gastroenterology, Galilee Medical Center, Nahariya 2221006, Israel.
Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 13100, Israel.
J Clin Med. 2020 Sep 12;9(9):2953. doi: 10.3390/jcm9092953.
Treatment of cholangitis complicating choledocholithiasis includes biliary sphincterotomy and stone extraction. In certain cases of elderly comorbid patients with high risk for definitive endoscopic treatment, biliary stenting is the only measure for relieving biliary obstruction.
We aimed to report the safety of retained biliary stone.
a multi-center, retrospective case-control study conducted at two Israeli medical centers from January 2013 to December 2018 including all patients 18 years of age or older who underwent ERCP and biliary stent insertion for the treatment of acute cholangitis due to choledocholithiasis.
Three-hundred and eight patients were identified. Eighty-three patients had retained long-term biliary stents of more than 6 months (group A) from insertion compared to 225 patients whose biliary stents were removed within a 6-month period (group B). The mean follow-up in group A was 66.1± 16.3 vs. 11.1 ± 2.7 weeks in group B. Overall complications during the follow-up were similar between groups A and B (6% vs. 4.9%, OR 1.24, Chi square 0.69). Similarly, the rate of each complication alone was not different when comparing group A to group B (3.6%, 1.2% and 1.2% vs. 2.7%, 0.44% and 1.8%) for cholangitis, stent related pancreatitis and biliary colic, respectively (Chi square 0.85). Even after 12 months, the rates of overall complications and each complication alone were not higher compared to less than 12 months (Chi square 0.72 and 0.8, respectively).
endoscopic biliary stenting for cholangitis complicating choledocholithiasis is safe for the long-term period without increase in stent related complications.
胆管炎合并胆总管结石的治疗包括胆管括约肌切开术和取石术。在某些老年合并症患者中，确定性内镜治疗风险较高，胆管支架置入是缓解胆道梗阻的唯一措施。
我们旨在报告残留胆管结石的安全性。
2013年1月至2018年12月在以色列的两家医疗中心进行了一项多中心回顾性病例对照研究，纳入所有18岁及以上因胆总管结石接受内镜逆行胰胆管造影术（ERCP）和胆管支架置入术治疗急性胆管炎的患者。
共确定了308例患者。83例患者长期保留胆管支架超过6个月（A组），而225例患者的胆管支架在6个月内取出（B组）。A组的平均随访时间为66.1±16.3周，B组为11.1±2.7周。随访期间A组和B组的总体并发症相似（6%对4.9%，比值比1.24，卡方值0.69）。同样，单独比较每种并发症的发生率时，A组和B组在胆管炎、支架相关胰腺炎和胆绞痛方面分别为（3.6%、1.2%和1.2%对2.7%、0.44%和1.8%），差异无统计学意义（卡方值0.85）。即使在12个月后，总体并发症和每种并发症的发生率与不到12个月时相比也没有更高（分别为卡方值0.72和0.8）。
内镜下胆管支架置入术治疗胆管炎合并胆总管结石长期安全，且支架相关并发症无增加。
