Multicenter experience with performance of ERCP in patients with an indwelling duodenal stent

Mouen A. Khashab, Ali Kord Valeshabad, Wesley Leung, Joel Camilo, Norio Fukami, Frederick Shieh, David Diehl, Rajeev Attam, Frank P. Vleggaar, Payal Saxena, Martin Freeman, Anthony Kalloo, Peter D. Siersema, Stuart Sherman

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Endoscopic retrograde cholangiopancreatography (ERCP) in patients with a preexisting duodenal stent covering the papilla is particularly challenging. The aim of this study was to describe a multicenter experience of performing ERCP in patients with biliary obstruction in whom the papilla was obscured by a preexisting duodenal stent. A total of 38 patients with preexisting duodenal stents obscuring the papilla underwent ERCP. Endoscopic biliary cannulation was successful in 13 patients (34.2%). In 12 of these 13 patients (92.3%), endoscopic therapy was performed during the same procedure and achieved clinical success with relief of jaundice in all cases (100%). The most commonly utilized procedure in patients in whom ERCP failed was EUS-guided biliary drainage (EGBD; n= 13/22, 59.1%), followed by percutaneous transhepatic biliary drainage (n= 9/22, 40.9%). Three patients in whom ERCP failed either did not consent to further intervention or were transferred to other centers. Thus, ERCP was technically challenging in our cohort of patients with preexisting duodenal stents, but was nonetheless successful in about one third of cases. Overall, when performed by experts, endoscopic biliary drainage (via ERCP or EGBD) can be successfully achieved in the majority of patients with indwelling duodenal stents.

Original languageEnglish (US)
Pages (from-to)252-255
Number of pages4
Issue number3
StatePublished - Mar 2014

ASJC Scopus subject areas

  • Gastroenterology


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