Neglected biliary stents: Clinical profile and outcomes
Mariyam Mohammad Mohammad, Dharshan Gowda, Anil Kumar K R, Harish Srikanth Kulkarni, Shravan Kumar PorikaObjectives
Endoscopic biliary stenting is a well-established method for biliary decompression in conditions such as choledocholithiasis and biliary strictures. Plastic biliary stents are intended for short-term use, requiring removal or exchange every 3-4 months. However, in resource-constrained settings, follow-up is often poor, leading to neglected stents and severe complications.
Material and Methods
This retrospective study was conducted at a tertiary care center, evaluating patients with neglected biliary stents who visited our department from January 2023 to December 2023. A total of 118 patients with biliary stents retained for more than 3 months were included. Demographic data, clinical presentation, complications, and management approaches were recorded. Endoscopic retrieval success rates and additional interventions were also documented.
Results
Among the 118 patients, the most common indication for biliary stenting was choledocholithiasis (45.7%), followed by benign biliary strictures (28.8%). The most frequent complication was cholangitis, occurring in 56% of patients, particularly in those with stents retained for over 6 months. Endoscopic retrieval was successful in 72% of cases, while 25.4% had stent migration requiring further intervention. Cholangioscopy was performed in two cases, and one patient underwent surgery. Lack of understanding regarding the need for stent exchange was the primary reason for neglect in 34% of patients.
Conclusion
Neglected biliary stents can result in serious complications, particularly cholangitis. The study emphasizes the need for improved patient education and communication to ensure timely follow-up and stent management. This research adds to the limited literature on neglected stents, especially in resource-limited regions, highlighting critical areas for intervention.