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Published on: March 25, 2022
Creation of a Durable Conduit with a Novel Self-Expandable Metal Stent for Stone Extraction in Endoscopic Retrograde
1Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
Background/Aims:
Despite technical advancements, various conditions such as bleeding diathesis and altered anatomy challenge the creation of a durable conduit for biliary stone removal in endoscopic retrograde Cholangiopancreatography (ERCP). A fully covered self-expandable metal stent (SEMS) has been used as a robust conduit for drainage in a wide spectrum of pancreatobiliary diseases. However, its primary use for stone removal has not been fully evaluated. This study aimed to evaluate the efficacy and safety of a novel fully covered SEMS that is 3 cm in length and has a wide distal flare as a durable conduit for stone extraction through the papilla.
Methods:
Twenty patients with common bile duct stones were enrolled prospectively and underwent ERCP with the novel SEMS. Primary outcomes were technical and therapeutic success rates. Secondary outcomes were the device removal success rate and any adverse events.
Results:
The technical and therapeutic success rates were 95% (19/20) and 90% (18/20), respectively. The novel SEMS was removed successfully in all patients (100%). Mild post-ERCP pancreatitis developed in 15% of the patients (3/20), and post-ERCP cholangitis occurred in 5% (1/20). There were no cases of moderate to severe pancreatitis, perforation, bleeding, or procedure-related mortality.
Conclusions:
The novel SEMS offers a durable conduit for safe and effective biliary stone extraction without major adverse events. Further studies in larger cohorts are warranted to confirm these findings (CRiS identifier KCT0006185).
