Abstract
Percutaneous Biliary Self Expandable Metal Stent (SEMS) in palliative treatment of Distal Common Bile Duct Obstruction – Experience from a Tertiary Medical Center
Rolando Rabot Jr, Evan Ong
Significance: Percutaneous biliary drainage is a well-established nonsurgical option for patients with failed ERCP. Conversion to an internal drainage is ideal, more so if a metal stent can be deployed to bypass the biliary obstruction thereby palliating the biliary obstruction and improving patient’s quality of life
Clinical Presentation: A retrospective review of five patients with distal CBD obstruction. One case did not undergo ERCP due to gastrojejunostomy for duodenal obstruction while the four other cases had failed ERCP. All five cases successfully underwent decompression using PTBD. Eventually, conversion to percutaneous SEMS insertion for internal drainage were considered in all cases.
Management: Percutaneous SEMS deployment was technically successful in all cases. A few modifications and techniques have been helpful in achieving the goal of full internal biliary drainage using SEMS. The addition of direct percutaneous cholangioscopy in selected cases as well as stent deployment under simultaneous fluoroscopic and endoscopic monitoring improves the precision and safety of the procedure.
Recommendation: Percutaneous biliary metal stenting can be an effective option for palliative treatment of distal common bile duct obstruction and improve a patient's quality of life.
Keywords: Distal CBD Obstruction; Palliative treatment; biliary SEMS
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |