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Metallic Stents in Benign Biliary Strictures

Long-Term Effectiveness and Interventional Management of Stent Occlusion

¹ All authors: Department of Diagnostic Radiology, University Clinics of Ulm, Robert-Koch-Str. 8, D-89081 Ulm, Germany.

View larger version (130K): [in a new window]   Fig. 1A. —65-year-old woman with recurrence of stricture at choledochojejunostomy after cholangioplasty. Choledochojejunostomy was performed after common bile duct injury during laparoscopic cholecystectomy. Cholangiogram obtained after entry via left hepatic duct shows short stricture (arrow) at level of choledochojejunostomy.

View larger version (110K): [in a new window]   Fig. 1B. —65-year-old woman with recurrence of stricture at choledochojejunostomy after cholangioplasty. Choledochojejunostomy was performed after common bile duct injury during laparoscopic cholecystectomy. Cholangiogram obtained 2 days after implantation of short Palmaz stent (arrow) (Cordis Endovascular; Haan, Germany) shows improved lumen diameter and drainage.

View larger version (127K): [in a new window]   Fig. 2A. —75-year-old women with Billroth II gastric resection and repeated balloon cholangioplasty via endoscopic approach. Cholangiogram shows stricture (arrow) of common bile duct.

View larger version (123K): [in a new window]   Fig. 2B. —75-year-old women with Billroth II gastric resection and repeated balloon cholangioplasty via endoscopic approach. Cholangiogram shows placement of Accuflex stent (arrows) (Boston Scientific Europe, Ratingen, Germany) to bridge stenotic segment.

View larger version (145K): [in a new window]   Fig. 2C. —75-year-old women with Billroth II gastric resection and repeated balloon cholangioplasty via endoscopic approach. Cholangiogram obtained after 24 hr shows stent dislodgement (arrows) into distal common bile duct. Early stent migration was probably caused by insufficient stent fixation in combination with eccentric stent implantation.

View larger version (111K): [in a new window]   Fig. 2D. —75-year-old women with Billroth II gastric resection and repeated balloon cholangioplasty via endoscopic approach. Final cholangiogram obtained after placement of second stent proximal to dislodged stent shows that after redilatation of both stents (arrows), there is free bile flow into duodenum.

View larger version (146K): [in a new window]   Fig. 3A. —57-year-old man with chronic pancreatitis. Cholangiogram shows recurrent short concentric stenosis (arrow) of papilla.

View larger version (153K): [in a new window]   Fig. 3B. —57-year-old man with chronic pancreatitis. Cholangiogram obtained after implantation of Accuflex stent (arrows) (Boston Scientific Europe, Ratingen, Germany) confirms good biliary drainage through prosthesis.

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