MANAGEMENT OF TUMOUR OBSTRUCTIONS OF DISTAL PART OF COMMON BILE DUCT USING RETROGRADE BILIARY STENTING

Abstract

The aim of this study is to improve endobiliary stenting in patients with tumour obstruction of the distal part of common bile duct, as well as to promote the prevention of complications, and improve immediate results of treatment and quality of life of patients.
 The study included 68 patients who took the course of treatment at surgical hospitals from 2018 to 2022 and underwent endoscopic transpapillary stenting of the common bile duct for mechanical jaundice. In 37 patients, stenting was performed using a plastic stent, in 31 patients stenting was performed using a nitinol stent. Results of endobiliary stenting, complications, effectiveness and safety of stenting were evaluated.
 All patients underwent stening of the common bile duct. During endoscopic retrograde biliary stenting, only 5 patients had complications in the form of bleeding from the area of large duodenal papilla that was stopped endoscopically. In early postoperative period, 12 patients had following complications: migration of plastic stent into duodenum (3 cases), obturation of plastic stent (1 case), acute secondary pancreatitis (6 cases), and cholangitis (2 cases). In 64 out of 68 patients, endobiliary stenting provided satisfactory outcomes resulting in the decompression of external bile ducts.
 Endoscopic transpapillary stenting of common bile duct is a low-traumatic, safe and effective method of the decompression of biliary tract when it is obstructed by a tumour. Depending on the expected life expectancy we should use nitinol stents (≥ 6 months) or plastic one (of ≤ 6 months).