[Endoscopic biliary stents for the temporary management of choledocholithiasis].

BACKGROUND Endoscopic extraction of biliary tract stones is safe and effective. When the procedure is not successful, the use of a temporary stent can be a solution. AIM To prospectively analyze the usefulness of endoscopic biliary stents in the temporary management of biliary obstruction due to choledocholithiasis. MATERIAL AND METHODS Analysis of 51 consecutive patients (age range 21-88 years, 34 females) with common bile duct stones that, from January 1999 to December 2001, were subjected to an endoscopic insertion of a biliary stent. RESULTS The indications for stent placement were a large stone in 40 patients (78%), the insecurity of a complete biliary tract cleaning in eight (16%) and technical difficulties in three (6%). Twenty seven patients (52.9%) were jaundiced and 17 (33.3%) had cholangitis. The prostheses remained in place until definitive resolution of the choledocholithiasis in 47 patients (92%) and migrated in 4 (8%). Bilirubin levels became normal in all cases with jaundice and infection resolved in all those with cholangitis. The definitive treatment of choledocholithiasis was done endoscopically in 28 patients (58%) and surgically in 20 (42%). Three patients were lost from follow up. Of these, one patient (2%) died 14 months later due to a recurrent cholangitis. The remaining two patients were asymptomatic and with the prostheses still in place 522 and 560 days post stent placement. CONCLUSIONS When the immediate endoscopic resolution of choledocholithiasis is not possible, temporary stenting is a simple and safe therapeutic alternative that allows patients to be free of obstructive complications until the definitive treatment is carried out.