Abstract

Plastic and metal biliary stents can fail to function properly, such failure being due to a positioning error or to the migration, occlusion, or fracture of the stent. An obstructed biliary stent can act as a nidus, causing complications such as recurrent persistent cholangitis. It can also cause vascular complications (such as bleeding and the formation of pseudoaneurysms), perforate the liver capsule (causing biloma or abscess), or, in rare cases, cause intestinal obstruction or perforation. In this pictorial essay, we demonstrate various interventional radiology techniques for the treatment of biliary stent dysfunction in patients with obstructive biliary disease.

Highlights

  • INTRODUCTIONA series of recently published studies conducted in Brazil have highlighted the importance of interventional radiology in the diagnosis and treatment of various diseases[1,2,3,4,5]

  • We demonstrate various interventional radiology techniques for the treatment of biliary stent dysfunction in patients with obstructive biliary disease

  • A series of recently published studies conducted in Brazil have highlighted the importance of interventional radiology in the diagnosis and treatment of various diseases[1,2,3,4,5]

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Summary

INTRODUCTION

A series of recently published studies conducted in Brazil have highlighted the importance of interventional radiology in the diagnosis and treatment of various diseases[1,2,3,4,5] Devices such as percutaneous transhepatic biliary drains, plastic biliary stents, and metal biliary stents are widely used to alleviate biliary obstruction in patients with inoperable tumors and in those with benign, postinflammatory, or iatrogenic stenosis. Such devices are inserted in the location of the stenosis with minimally invasive procedures either via endoscopic retrograde cholangiopancreatography (ERCP) or via ultrasound- or fluoroscopy-guided percutaneous transhepatic approaches[6]. Many complications have been described in the literature[6,7,8], we have not observed any major complications associated with the techniques evaluated

Failing plastic biliary stents
Relocation to the duodenal lumen
Removal through percutaneous transhepatic access
Failing metal biliary stents
Parallel placement
Perforating a covered stent
CONCLUSION
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