Agustos 2024
Proksimale migrate biliyer plastik stentlerin yönetimi: Tek merkez deneyimi
Management of proximal migrated biliary stents: Single center experience
- Ana Sayfa
- Sayılar
- Agustos 2024
- Proksimale migrate biliyer plastik stentlerin yönetimi: Tek merkez deneyimi...
Özet
ÖZET • Giris ve Amaç: Biliyer stentlerin migrasyonu beklenmeyen komplikasyonlardan biridir. Proksimale migre olan stentler ciddi komplikasyonlara yol açabileceginden, yönetimleri önemlidir. Bu çalismada proksimale migre stent saptadigimiz hastalarimizi degerlendirmek ve güncel medikal literatürü gözden geçirmeyi amaçladik. Gereç ve Yöntem: Eylül 2017-Kasim 2022 tarihleri arasinda Saglik Bilimleri Üniversitesi Adana Sehir Egitim ve Arastirma Hastanesinde endoskopik retrograd kolanjiopankreatografi islemi yapilan hastalar çalismaya alindi. Hastalarin dosyalari ve hastane veri tabani retrospektif olarak tarandi. Hastalarin klinik ve laboratuvar verileri kaydedildi. Bulgular: Çalismaya 57 hasta alindi. Ortalama yas 60.7 ± 14.5 (29-90) ve 30 (52.6%) hasta erkek idi. Otuz dört hasta basvuru aninda asemptomatik, diger hastalarda ise karin agrisi, sarilik veya ates sikayetleri vardi. On bes (%26.3) hastada kolanjit ve bes hastada basvuru sirasinda karaciger apsesi mevcuttu. Bir hasta proksimale migre stent ile iliskili kolanjit nedeniyle hayatini kaybetti. Otuz bir hastada proksimale migre stentler hastanemizde basarili bir sekilde çikarildi. Stent çikarilmasi sonrasi iki hastada endoskopik retrograd kolanjiopankreatografi islemi sonrasi komplikasyon gelisti (Bir hastada post endoskopik retrograd kolanjiopankreatografi pankreatiti ve bir hastada kanama). Dört hastada cerrahi girisim yapildi. Dokuz hastada migre olmus stentler dis merkezde çikarildi. On üç hastada migre olmus stentler çikarilamadi. Sonuç: Proksimale migre olmus biliyer stentler biliyer stentlerin önemli bir komplikasyonudur. Hastalar semptomatik veya asemptomatik olabilir. Proksimale migre olmus biliyer stentler kolanjit, karaciger apsesi ve hatta ölüme bile yol açabilirler. Bu nedenle erken tani ve uygun tedavi önemlidir. Proksimale migre olmus biliyer stentler endoskopik retrograd kolanjiopankreatografi islemi ile çikarilabilirler
Abstract
ABSTRACT • Background and Aims: Migration in biliary stents is one of the expected complications of biliary stenting. Since proximally migrated biliary stents may result in serious complications, management of proximally migrated biliary stents are important. In this study we aimed to evaluate our patients with proximally migrated biliary stents and review current medical literature. Materials and Methods: Patients with proximally migrated biliary stents who had endoscopic retrograde cholangiopancreatography application at Health Sciences University, Adana City Training and Research Hospital, Department of Gastroenterology between September 2017- November 2022 were included in the study. Patients’ files and electronic database of our hospital were screened and evaluated retrospectively. Patients’ clinic and laboratory data were recorded. Results: The study included 57 patients. Mean age was 60.7 ± 14.5 (29-90) and 30 (52.6%) were male. Thirty four patients were asymptomatic other remaining patients presented with abdominal pain, jaundice, or fever. Fifteen (26.3%) patients had cholangitis and five patients had liver abscess during presentation. One patient died due to cholangitis associated with proximally migrated biliary stents. In 31 patients, proximally migrated biliary stents were removed successfully in our hospital. After stent removal, two patients had post-endoscopic retrograde cholangiopancreatography complications (post-endoscopic retrograde cholangiopancreatography pancreatitis and bleeding). Four patients had surgical intervention. In nine patients, stents were removed in external centers. In 13 patients, proximally migrated biliary stents could not be extracted. Conclusions: Proximal migration of biliary stents is an important complication of biliary stenting. Patients may be asymptomatic or symptomatic. Proximally migrated biliary stents may result in serious complications such as cholangitis, liver abscess and even death. Thus, early diagnosis and proper treatment are important in these patients. Proximally migrated biliary stents may be removed in most patients with endoscopic retrograde cholangiopancreatography
