The use of endobiliary stents in the treatment of choledocholithiasis (review of literature)

Author(s):  A.A. Karpachev, Dr., Prof., Belgorod National Research University, Belgorod, Russia

A.V. Soloshenko, candidate of Sciences, associate Professor, Belgorod Regional Clinical Hospital, Belgorod , Russia

N.A. Linkov, Belgorod Regional Clinical Hospital, Belgorod , Russia

A.V. Gnashko, Belgorod National Research University, Belgorod , Russia

A.L. Iarosh, Dr., Prof., Belgorod National Research University, Belgorod, Russia

Issue:  Volume 42, № 2

Rubric:  Surgery

Annotation:  The treatment of complicated forms of gallstone disease remains a topical issue in modern surgery. Endoscopic papillosphincterotomy with lithoextraction(stone extraction) is the “gold standard” for the treatment of choledocholithiasis. In elderly and senile patients with severe comorbidities and high operational risk, endobiliary stenting is an alternative treatment method. While performing EPST and stenting of the common bile duct, the risk of developing an ascending infection and cholangitis increases. Endobiliary stenting, like any other implantation, is not a harmless procedure. Bacterial contamination of the stent occurs in a matter of hours after installation. The presence of biofilms on the surface of the implant leads to rapid incrustation of bile salts and obturation of the internal lumen of the stent, as well as concrements on its surface. Permanent replacement of stent in a short period of time, on one hand it is not economically viable and on other hand it causes discomfort to patients. All this dictates need to improve the endobiliary stents themselves. Objective deficiencies of internal drainage are pushing researchers to develop materials and methods for coatings that could increase the service life of stents and reduce the complication rate.

Keywords:  endobiliary stenting, difficult choledocholithiasis, obstructive jaundice, cholangitis, drug-eluting stent

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