Endoscopic stenting to treat biliary obstruction due to stones

The article is professionally consulted by Master, Doctor Nguyen Ngoc Thang - Gastroenterologist - General Surgery Department - Vinmec Da Nang International General Hospital

The advent of endoscopic retrograde cholangiopancreatography has created a great breakthrough in the management of biliary tract diseases, allowing direct intervention in the biliary tract for diagnosis as well as treatment, especially interventions. Treatment interventions such as removal of gallstones, common bile duct worms, bile duct stenting due to biliary obstruction... Endoscopic stenting for treatment of biliary obstruction due to stones is a minimally invasive procedure with high efficiency for patients. .

1. What is endoscopic stenting for biliary obstruction due to stones?


Endoscopic retrograde cholangiopancreatography for biliary-pancreatic stenting is a technique to insert metal or plastic stents through endoscopic cholangiopancreatography retrograde into the biliary tract or into the main pancreatic duct through a duodenoscope, with the aim of bile drainage into the duodenum.

2. In what case is endoscopic biliary stenting?


Cholangiocarcinoma in the liver hilum; Cholangiocarcinoma outside the liver hilum when surgery is no longer possible; Benign biliary atresia; Intestinal bile leak; Large bile duct stones cannot be removed immediately; Gallstones in the common bile duct, but patients in severe condition do not allow stones to be removed; Biliary tract infection requiring drainage. Contraindications for endoscopic biliary stenting in the following cases:
Dị ứng thuốc cản quang là tai biến kỹ thuật có thể gặp phải
Bệnh nhân bị dị ứng với thuốc cản quang chống chỉ định với nội soi đặt stent đường mật

Patients who have recently had a heart attack; Severe cardiopulmonary disease; Allergy to contrast agent ; Severe blood clotting disorders; Thrombocytopenia; Are taking antiplatelet drugs.

3. Advantages and disadvantages of endoscopic stenting to treat biliary obstruction due to stones


3.1 Advantages Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced technique in the field of endoscopic gastrointestinal - hepatopancreatic. The most obvious advantage is that while other endoscopic procedures have only observational, diagnostic, or therapeutic functions, ERCP includes both.
Endoscopic cholangiopancreatic stenting allows precise positioning of stones and successful removal of stones. This is a non-invasive, safe, and less traumatic method because it has little impact on the patient's body, minimizes complications, and is still highly effective, helping patients not need to perform a major surgery. so you will recover quickly and return to your daily life soon.
Nội soi mật tụy ngược dòng
Nội soi mật tụy ngược dòng

3.2 Disadvantages This method has the disadvantage of not allowing direct observation of pathological lesions in the biliary tract, as well as not performing some techniques of direct therapeutic intervention on the pathological lesions of the patient. honey.
Besides, endoscopic stenting to treat biliary obstruction due to stones is a difficult technique, requiring experience and specialized skills of technicians.

4. Preparation before performing endoscopic biliary stenting


The patient needs to fast for at least 6 hours before performing this technique to ensure that the stomach and duodenum are clean and free of food; The doctor must be aware of all the medications the patient is taking; The patient must not have a history of allergy to the iodine in the contrast medium; Antibiotics should be taken before the procedure and continued for a few more days after.

5. Caring for patients after surgery

Chít hẹp đường mật
Bệnh nhân sau phẫu thuật cần được tái khám thường xuyên để sớm phát hiện các triệu chứng chít hẹp đường mật tái phát

After surgery, the patient should be closely monitored to quickly detect complications (if any); Patients are usually kept in the hospital until fully awake from anesthesia, and no complications occur; To ensure that the stent is working properly, the patient should be seen regularly for early detection of recurrent biliary strictures. These symptoms include: change in the color of stool and urine, jaundice, itching, abnormalities in liver function tests.

6. Complications of laparoscopic biliary stenting surgery


Complications include major bleeding, infection, pancreatitis, cholangitis, cholecystitis, and duodenal injury; Specific complications of stents include: Displacement, obstruction, and bowel perforation. Endoscopic stenting for biliary obstruction due to stones is a minimally invasive procedure with high efficiency for patients. However, to achieve high efficiency, patients should choose reputable medical facilities and specialized hospitals to perform.
The Department of Gastroenterology of Vinmec International General Hospital always receives satisfaction and high appreciation from customers by the quality of treatment, medical equipment and patient care services.
Top modern equipment in Vietnam: High resolution flexible gastrointestinal endoscope to detect cancer at early stage and accurate digestive diseases. American surgical robot has high precision, less invasive, fast patient recovery time. Team of highly qualified doctors: The doctors are well-trained at the leading surgical centers of Vietnam, Korea, Singapore, Japan, with high professional qualifications. Participate in short-term training courses abroad, update the latest techniques and treatment regimens in the world. Diagnosing and treating digestive diseases with the latest technology: Robotic endoscopic surgery with a success rate of up to 95%. Gastrointestinal endoscopy is painless and painless. Comprehensive patient care: Being the first hospital in Vietnam to apply the program of early recovery after surgery (ERAS), which shortens the hospital stay to only 3 - 5. Complication rate, cost of patients is reduced, bringing many benefits to customers. To examine and treat with the leading doctors of Gastroenterology - Vinmec International General Hospital, please click the "Contact Us" button on the website, or register for an online examination.

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