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Yamaguchi A, Kato N, Sugata S, Hamada T, Furuya N, Mizumoto T, Tamaru Y, Kusunoki R, Kuwai T, Kouno H, Kohno H. Efficacy of a novel integrated biliary stent and nasobiliary catheter system for accidental tube deviation in biliary drainage. Endosc Int Open 2023; 11:E859-E865. [PMID: 37719800 PMCID: PMC10504041 DOI: 10.1055/a-2125-3896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/29/2023] [Indexed: 09/19/2023] Open
Abstract
Background and study aims Endoscopic nasobiliary drainage is accompanied by a risk of accidental removal of the nasobiliary drainage (NBD) tube, especially through self-removal in elderly patients. We studied the usefulness of an integrated biliary stent and nasobiliary catheter system (UMIDAS NB stent) for biliary drainage in case of accidental NBD tube removal. Patients and methods From April to November 2022, we placed a UMIDAS NB stent in 30 patients with acute cholangitis or obstructive jaundice. We evaluated the plastic stent (PS) position at the time of accidental stent removal and before the planned endoscopic procedure. In addition, we studied the ratio of successful biliary drainage and complications based on the usage of UMIDAS. Results All 11 patients with accidental stent removal exhibited correct PS position in X-ray fluoroscopy. Of the 19 patients with planned NBD tube removal, three had complete PS migration into the common bile duct and three had incomplete migration (the duodenal side flap entered the bile duct). In summary, 80% (24/30) of PS were in the correct position, and all patients had successful biliary drainage and no complications. Conclusions The UMIDAS NB stent might be useful for biliary drainage in patients with a high risk of NBD tube self-removal.
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Affiliation(s)
- Atsushi Yamaguchi
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Naohiro Kato
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Syuhei Sugata
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Takuro Hamada
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Nao Furuya
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Takeshi Mizumoto
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Yuzuru Tamaru
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Ryusaku Kusunoki
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Toshio Kuwai
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Hirotaka Kouno
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Hiroshi Kohno
- Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
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Kuniyoshi N, Imazu H, Nomura S, Hamana S, Osawa R, Yamada K, Fujisawa M, Moriyama M. Endoscopic biliary drainage using a 4-Fr catheter for biliary obstruction: a pilot study. MINIM INVASIV THER 2022; 31:1035-1040. [DOI: 10.1080/13645706.2022.2090004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Noriyuki Kuniyoshi
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroo Imazu
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Shuzo Nomura
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Suguru Hamana
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Rota Osawa
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Kouji Yamada
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Mariko Fujisawa
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Mitsuhiko Moriyama
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
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Zhang C, Yang YL, Ma YF, Zhang HW, Li JY, Lin MJ, Shi LJ, Qi CC. The modified pancreatic stent system for prevention of post-ERCP pancreatitis: a case-control study. BMC Gastroenterol 2017; 17:108. [PMID: 29047328 PMCID: PMC5648421 DOI: 10.1186/s12876-017-0661-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 10/02/2017] [Indexed: 12/20/2022] Open
Abstract
Background Prophylactic pancreatic stents after endoscopic retrograde cholangiopancreatography (ERCP) can help prevent post-ERCP pancreatitis. However most of the pancreatic stents need to be removed by another ERCP. The aim of this observational study was to investigate the feasibility and effectiveness of the modified pancreatic stent system for prevention of post-ERCP pancreatitis. Methods From November 2013 to November 2015, a total of 230 patients who had prophylactic pancreatic stent placed for prevention of post-ERCP pancreatitis at a single institution were identified and stratified. In this case-control design, 150 patients received an ordinary pancreatic stent, and 80 patients received the modified pancreatic stent. The main outcome measures were the difficulty level and complications of pancreatic stent placement and extraction between the two groups. Results In ordinary group, the average time of pancreatic stent and nasal biliary drainage placement was 3.5 ± 0.6 min. There were 13 cases of stent proximal migration (8.7%), 20 cases of stent spontaneous abscission (13.3%), 5 cases of acute pancreatitis (3.3%) (2 cases for stent abscission) and 7 cases of hyperamylasemia (4.7%) after ERCP. One hundred thirty patients received extra duodenoscope (86.7%) to remove the stent, and 4 cases had acute pancreatitis and 5 patients had hyperamylasemia after removing the proximal migratory stents. In modified group, the average time of pancreatic stent system placement was 4.9 ± 0.7 min, but there was only one case of stent abscission (1.3%), 2 cases of acute pancreatitis (2.5%) and 3 cases of hyperamylasemia (3.8%). The new pancreatic stents were removed directly under x-ray without complication. Conclusions The modified pancreatic stent system has the same effect of preventing post-ERCP pancreatitis, lower rate of stents proximal migration and spontaneous abscission, and the advantage of easier removed compared with ordinary pancreatic stent.
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Affiliation(s)
- Cheng Zhang
- Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China
| | - Yu-Long Yang
- Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China.
| | - Yue-Feng Ma
- Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China
| | - Hong-Wei Zhang
- Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China
| | - Jing-Yi Li
- Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China
| | - Mei-Ju Lin
- Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China
| | - Li-Jun Shi
- Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China
| | - Chun-Chun Qi
- Department of Biliary Minimally Invasive Surgery, Affiliated Zhongshan Hospital of Dalian University, No, 6. Jiefang Road, Zhongshan District, Dalian, Liaoning Province, 116001, People's Republic of China
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