[Trimming with argon plasma of self-expanding metal stents: report of 7 cases]

Acta Gastroenterol Latinoam. 2014 Jun;44(2):121-4.
[Article in Spanish]

Abstract

The use of self-expandable enteral stents for palliation of malignant stenosis may present the complication of concealing the ampulla of Vater behind the metallic mesh. Anchoring in the duodenal wall (distal or partial migration) may also be a complication of biliary metallic stents and therefore may cause difficulty in gaining access to the biliary tract. In these cases of difficult access, a fenestration on the prosthesis ( biliary or enteral) can be created to allow reaching the obstructed biliary tract by means of argon plasma (AP). Were retrospectively analysed 7 cases. Under endoscopic vision, AP was directed to filgurate and cut 6 biliary prosthesis and a duodenal stent. Fulguration and cut of biliary stent was performed in 5 cases of distal partial migration and cholangitis. In one case of obstruction caused by distal migration inside the duodenal stent light, cutting of the biliary stent was performed. A window was created in the enteral prosthesis in order to access the ampulla of Vater and place a biliary tract prosthesis. All cases were resolved successfully and without complications. We conclude that the use of AP to fulgurate and cut nitinol prosthesis was effective and presented no complications in this series.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Argon Plasma Coagulation*
  • Device Removal
  • Duodenal Obstruction / etiology
  • Duodenal Obstruction / therapy*
  • Humans
  • Middle Aged
  • Palliative Care
  • Pancreatic Neoplasms / complications*
  • Pancreatic Neoplasms / therapy
  • Retrospective Studies
  • Stents*