Long-Term Safety of Endoscopic Biliary Stents for Cholangitis Complicating Choledocholithiasis: A Multi-Center Study
Abstract
:1. Introduction
2. Materials and Methods
3. Study Endpoints
3.1. Types of Stents Used within Our Cohort
3.2. Statistical Analysis
4. Results
4.1. Baseline Demographics, Clinical and Laboratory Characteristics
4.2. Overall Complications during the Follow-Up Period
4.3. Sub-Analysis According to Each Complication Alone
4.4. Complications Rate According to Stent Type
5. Discussion
Author Contributions
Funding
Conflicts of Interest
Abbreviations
CBD | Common bile duct |
CI | Confidence interval |
ERCP | Endoscopic retrograde cholangiopancreatography |
OR | Odds ratio |
SD | Standard deviation |
References
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Parameters | Group A (>6 Months) | Group B (<6 Months) |
---|---|---|
Number of patients | 83 | 225 |
Age (years), Mean ±SD (range) | 83.5 ± 4.8 (67–98) | 61.3 ± 17.9 (20–93) |
Gender, N (%) | ||
Male | 54 (65.1) | 142 (63.1) |
Female | 29 (34.9) | 83 (36.9) |
History of cholecystectomy, N (%) | 23 (29.3) | 0 |
Gallbladder stones, N (%) | 31 (37.3) | 164 (72.9) |
Cause of stent insertion, N (%) | ||
Hemodynamic instability | 56 (67.5) | 0 |
Technically difficult ERCP | 25 (30.1) | 0 |
Sedation related complications | 2 (2.4) | 0 |
Preventive | 0 | 225 (100) |
Stone extraction during ERCP, N (%) | ||
No stone extraction | 64 (77.1) | 0 |
Incomplete stone clearance | 19 (22.9) | 0 |
Complete stone extraction | 0 | 225 (100) |
Complication of ERCP, N (%) | ||
None | 72 (86.8) | 209 (92.9) |
Post ERCP pancreatitis | 11 (13.2) | 16 (7.1) |
Bleeding | 0 | 0 |
Perforation | 0 | 0 |
Cholangitis | 0 | 0 |
Mean follow-up in weeks, Mean ±SD (range) | 66.1 ± 16.1 (30–100) | 11.1 ± 2.7 (5–18) |
Stent type, N (%) | ||
Plastic | 71 (85.6) | 217 (96.4) |
Metallic | 12 (14.4) | 8 (3.6) |
Normalization of liver enzymes during follow-up | 65 (91.5) | 160 (95.2) |
Cholecystectomy performed during follow-up, N (%) | 5 (6) | 225 (100) |
All Complications, N (%) | Cholangitis N, (%) | Stent Related Pancreatitis, N (%) | Biliary Colic, N (%) | |
---|---|---|---|---|
Primary endpoint analysis | ||||
<6 months | 11 (4.9) | 6 (2.7) | 1 (0.44) | 4 (1.8) |
>6 months | 5 (6) | 3 (3.6) | 1 (1.2) | 1 (1.2) |
Secondary endpoint analysis | ||||
<12 months | 12 (5) | 7 (2.9) | 1 (0.4) | 4 (1.6) |
>12 months | 4 (6.1) | 2 (3) | 1 (1.5) | 1 (1.5) |
Secondary endpoint analysis | ||||
<18 months | 15 (5.2) | 9 (3.1) | 2 (0.7) | 4 (1.4) |
>18 months | 1 (5.3) | 0 | 0 | 1 (5.3) |
Endpoints | Chi Square Statistics |
---|---|
Primary endpoint analysis (<6 vs. >6 months) | |
All complications | 0.7 |
Each complication alone | 0.8 |
Secondary endpoint analysis (<12 vs. >12 months) | |
All complications | 0.7 |
Each complication alone | 0.8 |
Secondary endpoint analysis (<18 vs. >18 months) | |
All complications | 0.9 |
Each complication alone | 0.5 |
Type of Stent | Plastic Stents | Metallic Stents | ||
---|---|---|---|---|
<6 vs. >6 Months | <6 vs. >6 Months | |||
Number of patients | 217 | 71 | 8 | 12 |
All complications, N (%) | 11 (5.1) | 4 (5.6) | 0 | 1 (8.3) |
Cholangitis N, (%) | 6 (2.7) | 3 (4.2) | 0 | 0 |
Stent related pancreatitis, N (%) | 1 (0.46) | 0 | 0 | 1 (8.3) |
Biliary colic, N (%) | 4 (1.8) | 1 (1.4) | 0 | 0 |
Chi Square Statistics | ||||
---|---|---|---|---|
All Complications | Each Complication Alone | |||
Plastic | Metallic | Plastic | Metallic | |
Primary endpoint analysis < 6 vs. > 6 months | 0.8 | 0.4 | 0.86 | 0.56 |
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Sbeit, W.; Khoury, T.; Kadah, A.; M. Livovsky, D.; Nubani, A.; Mari, A.; Goldin, E.; Mahamid, M. Long-Term Safety of Endoscopic Biliary Stents for Cholangitis Complicating Choledocholithiasis: A Multi-Center Study. J. Clin. Med. 2020, 9, 2953. https://doi.org/10.3390/jcm9092953
Sbeit W, Khoury T, Kadah A, M. Livovsky D, Nubani A, Mari A, Goldin E, Mahamid M. Long-Term Safety of Endoscopic Biliary Stents for Cholangitis Complicating Choledocholithiasis: A Multi-Center Study. Journal of Clinical Medicine. 2020; 9(9):2953. https://doi.org/10.3390/jcm9092953
Chicago/Turabian StyleSbeit, Wisam, Tawfik Khoury, Anas Kadah, Dan M. Livovsky, Adi Nubani, Amir Mari, Eran Goldin, and Mahmud Mahamid. 2020. "Long-Term Safety of Endoscopic Biliary Stents for Cholangitis Complicating Choledocholithiasis: A Multi-Center Study" Journal of Clinical Medicine 9, no. 9: 2953. https://doi.org/10.3390/jcm9092953