Abstract
Aim: To clarify the clinical efficacy of endoscopic biliary stenting (EBS) in high risk patients with choledocholithiasis. Patients and Methods: 24 high risk patients with choledocholithiasis who underwent EBS without stone extraction were included (EBS group). Early complications and long-term results in the EBS group were compared with those in 634 patients who underwent complete stone removal (stone removal group). Results: Although early complications occurred more frequently in the EBS group than in the stone removal group (25% vs. 10%, p=0.03), no serious complications were seen in the EBS group. In the EBS group, late complications occurred in 6 patients. Development of cholangitis in all cases in which it occurred was caused by stent obstruction or migration. Moreover, 2 patients died of sepsis resulting from severe cholangitis. In the stone removal group, 19 high risk patients were followed up for a long-term. Among them, cholangitis occurred in 1 patient. The mean time to development of cholangitis in the EBS group was shorter than in the stone removal group (1377 days vs. 2272 days, p=0.57). Conclusions: EBS in high risk patients with choledocholithiasis should be mentioned that cholangitis due to stent dysfunction may occur.
