Multiple plastic biliary stent placement in the management of large and multiple choledochal stones: single center experience and review of the literature

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dc.contributor.authorBektas, Hasan
dc.contributor.authorGurbulak, Bunyamin
dc.contributor.authorSahin, Zeynep Deniz
dc.contributor.authorDuzkoylu, Yigit
dc.contributor.authorColak, Sukru
dc.contributor.authorGurbulak, Esin Kabul
dc.contributor.authorGunes, Mehmet Emin
dc.date.accessioned2025-03-26T17:34:43Z
dc.date.available2025-03-26T17:34:43Z
dc.date.issued2017
dc.departmentİstanbul Esenyurt Üniversitesi
dc.description.abstractIntroduction: Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is the first step treatment modality of choledocholithiasis. In spite of an extended sphincterotomy, 10-15% of complex choledochal stones (larger than 15 mm and/or more than 3 stones) cannot be removed and recurrent ERCP procedures may be needed. Aim: To evaluate the role and efficiency of multiple biliary stent application in the treatment of large and multiple choledochal stones. Material and methods: Patients with complex choledochal stones and patients with inadequate choledochal clearance during ERCP were included in the study. The study group was divided into 2 groups as the placement of single (n = 27 patients) or multiple stents (n = 58 patients). After a mean time interval of 21 days (10-28), the ERCP procedure was tried for the second time and a stent was placed in case of recurrence. Results: Successful biliary drainage was provided in both groups. The decrease in the longitudinal or transverse size of the stones after stent placement was found to be statistically significant in both groups (p = 0.001). Cholestatic enzymes (alkaline phosphatase (ALP), g-glutamyltransferase (GGT)) and bilirubin levels decreased significantly in both groups following stenting (p = 0.001). Additionally, multiple stents functioned as a bridge starting from the first ERCP to full clearance in patients with large and multiple stones which could not be removed at once and saved them from the possible morbidities of an invasive operation. Conclusions: Endoscopic multiple biliary stent placement should be preferred in the treatment of patients with complex choledochal stones and high rates of co-morbidity, as a safe alternative to surgery.
dc.identifier.doi10.5114/wiitm.2017.69107
dc.identifier.endpage237
dc.identifier.issn1895-4588
dc.identifier.issn2299-0054
dc.identifier.issue3
dc.identifier.pmid29062442
dc.identifier.scopus2-s2.0-85031690038
dc.identifier.scopusqualityQ2
dc.identifier.startpage231
dc.identifier.urihttps://doi.org/10.5114/wiitm.2017.69107
dc.identifier.urihttps://hdl.handle.net/20.500.14704/860
dc.identifier.volume12
dc.identifier.wosWOS:000412199700004
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherTermedia Publishing House Ltd
dc.relation.ispartofVideosurgery and Other Miniinvasive Techniques
dc.relation.publicationcategoryDiğer
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250326
dc.subjectendoscopic retrograde cholangiopancreatography (ERCP); choledocholithiasis; multiple plastic biliary stents
dc.titleMultiple plastic biliary stent placement in the management of large and multiple choledochal stones: single center experience and review of the literature
dc.typeReview

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