BILE VISCOSITY IN PATIENTS WITH BILIARY DRAINAGE - EFFECT OF COTRIMOXAZOLE AND N-ACETYLCYSTEINE AND ROLE IN STENT CLOGGING

Background: The main disadvantage of endoscopic insertion of an endopr osthesis is the tendency of the stent to clog after a few months. In t his study we determined the role of bile viscosity in stent clogging. Methods: Sixty patients were stented with 10 Fr 11-cm stents. The sten ts were electively removed after 2 months, and a bile sample was obtai ned simultaneously. Bile viscosity was measured with a coaxial rotatio n viscometer. The influence of treatment with antibiotics and a mucoly tic agent on viscosity was assessed in a randomized trial. Results: Bi le viscosity correlated significantly with DNA and total protein conce ntration. After treatment with either N-acetylcysteine or co-trimoxazo le a lower mean value of the viscosity was observed, but this was not statistically significant. There was no correlation between bile visco sity and the amount of sludge adhering to the stents. Conclusions: In most patients bile viscosity plays a limited role in stent clogging. O nly in patients with excessively high viscosity do mucolytic agents or treatment with antibiotics seem to have a role.