Single centre experience with usage of biodegradable stents during endoscopic retrograde cholangiopancreatography

Introduction

The introduction of biodegradable stents have played an important role in the management of benign biliary and pancreatic diseases. The aim of this retrospective study was to look at the indications, feasibility and outcome of the usage of biodegradable stents during Endoscopic Retrograde Cholangiopancreatography (ERCP) in a real world setting in a single centre.

Methods

This retrospective study looked at all patients who underwent an Endoscopic Retrograde Cholangiopancreatography from November 2020 to June 2022. The data of patients who had a ARCHIMEDES™ biodegradable stent(s) inserted were extracted and their clinical data, ERCP reports and post procedure outcomes were reviewed and analysed.

Results

23 patients had biodegradable stents inserted during their ERCP. 17 patients (73.9%) had biliary biodegradable stents inserted and 6 (26.1%) had pancreatic biodegradable stents inserted. Slow degrading stents were inserted for 19 patients (82.6%) and Fast degrading stents were inserted for 4 patients (17.4%). Indications for biliary stents were bile leak post cholecystectomy (13 patients, 76.5% of biliary stents) and oedematous ampulla with baggy common bile duct with complete stone clearance (4 patients, 23.5% of biliary stents). Pancreatic duct stents were inserted for prevention of pancreatitis in patients who had inadvertent cannulation of pancreatic duct twice or more in 4 patients (17.4%), pancreatic duct disruption in 1 patient (4.3%) and post successful pancreatic stricture dilatation for pancreatic remodeling in 1 patient (4.3%). Stent insertion was successful for all patients (100%) and at first attempt in 22 patients (95.7%). All cases for which stents were inserted for bile leaks had a resolution of bile leak (100%). None of the patients with a pancreatic biodegradable stent inserted developed post procedure pancreatitis. The overall success of the biodegradable stents in achieving intended therapeutic goal was 91.3% with only one (4.3%) adverse event of cholangitis post procedure.

Conclusions

Usage of biodegradable biliary and pancreatic stents during ERCP is beneficial as it has a convincing feasibility, has an excellent clinical outcome and prevents the need of repeat endoscopic procedures for stent removal.