| Stenting of biliary and pancreatic duct for recurrent papillary stenosis |
 |
 |
|
Recurrent bouts of
cholangitis with a fibrotic papillary
stenosis resistent to therapyled to the implantation
of a
plastic stent. The papillary stenosis also led to chronic
pancreatitis with a remarkable dilatation of the pan-
creatic duct (x-ray to the right).
To the left: The papilla is depicted with a little pus
draining from it. Though papillotomized and di-
lated several times the stenosis is visible.
|
 |
 |
|
The
dilated pancreatic duct corresponding to chronic
pancreatic pain was treated by insertion of a prothesis
to the pancreatic duct.
On the left side the endoscopic picture is shown, the
x-ray to the right shows both stents in situ.
|
 |
 |
 |
Since the biliary stents
occluded nearly once in a month,
the dicision is made to deploy a wall stent.
The upper left picture shows the stent not yet fully ex-
panded, on the x-ray above to the right the stent is fully
expanded and in the correct position. The left lower endo-
scopic picture shows both the pancreatic and the wall
stent in the papilla.
Since recurrent cholangitis might be induced by biliary
metall stents, the indication in this case was an extreme
exception. Reasons for metall stenting in this case were
the recurrent stent occlusions, the old age of the
patient
(85) and the comorbidity (maximal surgical risk). |
