Ретроградное стентирование желчевыводящих путей при патологии панкреатобилиарной области

2013 
Aim. To evaluate the results of retrograde biliary stenting in patients with pancreatobiliary diseases. Methods. In 2008-2012, 85 retrograde biliary stenting procedures were performed in 65 patients (28 men and 37 women) with pancreatobiliary diseases aged 33 to 86 years. Obstructive jaundice was diagnosed in 44 of 65 patients (in 67% of cases), ascending cholangitis — in 14 (21%) patients. Endoscopic biliary stenting was performed in 47 patients with benign pancreatobiliary diseases (chronic and post-surgical pancreatitis, benign common bile duct stricture, Mirizzi syndrome, intradiverticular papilla, common bile duct bile stones) and in 18 patients with malignancies (cancers of pancreas head, bile ducts and papillary cancer). Plastic biliary stents with a (diameter 2.5 to 3.3 mm) were used for stenting. Results. Endoscopic biliary stenting allows to resolve the clinical manifestations of оbstructive jaundice and cholangitis, to eliminate pain, to prevent the development of pancreatitis, to prepare patients for surgery. Serious complications of biliary stenting (stent migration in common bile duct, acute cholangitis) were observed in 5 of 85 procedures (5.9% of cases), and all were resolved after repeated endoscopic intervention. Conclusion. Endoscopic retrograde biliary stenting is a safe and effective treatment option for patients with both benign and malignant pancreatobiliary diseases, it is characterized by low rate of specific complications (5.8%) and had reduced the risk of acute pancreatitis in patients with papillostenosis and stricture of the common bile duct terminal part down to 3%.
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