Features of endobiliary stenting in unresectable tumors in the hepatopancreatoduodenal zone

Aim. Optimization of endobiliary stenting in patients with unresectable tumors of the organs in the hepatopancreatoduodenal zone, improving the prevention of complications, improving the immediate results of treatment and the quality of patient’s life.

Material and methods. From 2011 to 2020, 47 patients with unresectable tumors in the hepatopancreatoduodenal zone underwent endoscopic transpapillary stenting of the common bile duct for obstructive jaundice. A plastic stent was used in 28 patients, and a self-expanding nitinol stent in 19 patients. The results of endobiliary stenting, complications, efficacy and safety of stenting, side effects, quality of biliary tract decompression were evaluated.

Results. All patients were perform stenting of the common bile duct. Two complications were recorded during endoscopic transpapillary stenting: bleeding from the area of the major duodenal papilla, which was stopped endoscopically. In the immediate postoperative period – stent displacement was noted in 3 patients, blockage of the stent – in 2 cases, acute post-manipulative pancreatitis – in 1 case, cholangitis — in 2 patients. Satisfactory decompression of the biliary tract was achieved in 44 from 47 patients. There was 1 death.

Conclusion. Endoscopic transpapillary stenting of the common bile duct is a low-traumatic, safe and effective method of biliary decompression for tumor obstructive jaundice. Plastic stents should be used for biliary drainage with a life expectancy of ≤6 months. Self-expanding nitinol stents with full or partial coverage is the best chose for life expectancy > 6 months.

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