November 12, 2014
Notes: Issa, Y
van Santvoort, H C
van Goor, H
Cahen, D L
Bruno, M J
Boermeester, M A
Dig Surg. 2013;30(1):35-50. doi: 10.1159/000350153. Epub 2013 Apr 26.
Author Address: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Reference Type: Journal Article
Record Number: 5273Author: Itoi, T., Tsuchiya, T., Tanaka, R., Ikeuchi, N. and Sofuni, A.
Title: Lethal post-endoscopic retrograde cholangiopancreatography pancreatitis following fully covered metal stent placement in distal biliary obstruction due to unresectable cholangiocarcinoma
Journal: Dig Endosc
Volume: 25 Suppl 2
Short Title: Lethal post-endoscopic retrograde cholangiopancreatography pancreatitis following fully covered metal stent placement in distal biliary obstruction due to unresectable cholangiocarcinoma
Alternate Journal: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661 (Electronic)
Accession Number: 23617661
Keywords: Aged, 80 and over
Bile Duct Neoplasms/diagnosis/*surgery
Bile Ducts, Intrahepatic/*surgery
Cholangiopancreatography, Endoscopic Retrograde/*adverse effects
Coated Materials, Biocompatible/adverse effects
Abstract: Biliary self-expandable metallic stent (SEMS) is the preferred and first-line therapy for unresectable malignant biliary obstruction. To date, several reports have revealed the relatively high incidence of acute complications such as pancreatitis and cholecystitis due to mechanical stent compression. In the present case, we encountered fatal pancreatitis following fully covered metal stent placement. An 85-year-old man had middle bile duct strictures due to cholangiocarcinoma. A 10-mm diameter fully covered SEMS was placed across the papilla for biliary decompression. Laboratory data and physical evidence the following day revealed acute pancreatitis. Therefore, antibiotics and protein degeneration enzyme inhibitors were given. However, his condition did not improve. Two days after the procedure, we removed the stent and returned him to his original hospital. Serum amylase level decreased below 400 mg/dL 6 h after the procedure. However, the acute pancreatitis worsened. Although we treated the patient in the intensive care unit, he died 32 days after the second admission.