LACK OF COMPLICATIONS FOLLOWING SHORT-TERM STENT THERAPY FOR EXTRAHEPATIC BILE-DUCT STRICTURES IN PRIMARY SCLEROSING CHOLANGITIS

Background: In 10% to 20% of patients with primary sclerosing cholangi tis, a dominant stricture of an extrahepatic bile duct is responsible for symptoms and an exacerbation of cholestasis. The complications of a dominant stricture can usually be relieved by endoscopic; placement of a stent through the stricture. The conventional policy of leaving s tents in situ for 2 to 3 months is associated with a high incidence (e .g., 50%) of clinical deterioration due to stent occlusion. We have at tempted to overcome this problem by substantially reducing the duratio n of stent placement. Methods: Sixteen patients with symptomatic prima ry sclerosing cholangitis and dominant extrahepatic bile duct strictur es were treated by stent placement for a median interval of only 9 day s, Results: In all patients endoscopic stent therapy was technically s uccessful with a 7% incidence of transient procedure-related complicat ions. During median follow-up of 19 months (range 7 to 27 months) seru m biochemical evidence of cholestasis decreased substantially and 13 ( 81%) of the 16 patients became asymptomatic. No patient had a recurren ce or exacerbation of either symptoms or biochemical evidence of chole stasis that could be attributed to stent occlusion.Conclusions: Short- term endoscopic stent therapy is a safe and effective treatment for sy mptomatic dominant extrahepatic bile duct strictures in patients with primary sclerosing cholangitis.