内镜治疗慢性胰腺炎合并胆总管良性狭窄22例

Risk factors for biliary stent migration in patients with benign biliary strictures

AIM: To investigate risk factors for stent migration in patients with benign biliary strictures.

METHODS: The clinical data for 244 patients who underwent endoscopic retrograde biliary drainage (ERBD) for benign biliary strictures (BBS) from January 2005 to December 2009 were retrospectively reviewed. Details noted included the cause and location of stricture, length and number of stents, direction of stent migration, manifestations of patients with migrated stent, and methods used for retrieval of migrated stents.

RESULTS: Four hundred and eight biliary plastic stent placement procedures were performed for benign biliary strictures in 244 patients. There were 56 migrated stents identified. Compared to other causes, stricture after biliary duct exploration was associated with a significantly lower migration rate (6.8% vs 21.18%, χ² = 42.585, P < 0.001). Migration direction was associated with the location of stricture (23.1% vs 76.9%; 73.3% vs 26.7%, both P < 0.001). The length of stent is associated with migration direction (23.1% vs 73.3%; 76.9% vs 26.7%, both P < 0.001). Short stent tends to migrate proximately, whilst long stent more often migrates distally. Both single and double stent placement was associated with higher migration rate than multiple stent placement (19.3%, 20.9% vs 2.7%, both P < 0.001). However, there is no significant difference in migration rate between single and double stent placement. The number of stents was not associated with migration direction. All migrated stents could be successfully retrieved endoscopically.

CONCLUSION: The risk factors for plastic stent migration in patients with benign biliary duct strictures include etiology of stricture, location of stricture, length and number of stents. Therefore, stent migration rate can be significantly reduced if the above conditions are carefully assessed in clinical practice.