Biliyer stent komplikasyonları

Özet

Biliyer stentler safra yolu tıkanıklığını gidermek ve darlıkları tedavi etmek için kullanılır; yerleştirilmeleri tıkanma, kolanjit, pankreatit, perforasyon ve migrasyon gibi erken veya geç komplikasyonlarla ilişkili olabilir. BT, biliyer stent migrasyonunu ve bağırsak perforasyonu gibi ilişkili komplikasyonları gösterebilir. BT, stent ilişkili komplikasyonların zamanında tanınmasında ve yönetim kararlarının verilmesinde değerlidir. Biliyer stent migrasyonu kolanjit veya bağırsak perforasyonuyla ilişkili olabilir.

Faz ve pencere

Portal tanısal

Kontrastlı portal venöz faz stent konumu ve bütünlüğünü, üst taraf intrahepatik kanal genişlemesini, kanal duvarı/periduktal inflamasyonu, karaciğer apsesini, bilomayı ve perforasyon çevresi inflamasyonu birlikte değerlendirir.

Kontrastsız tanısal

BT'de pnömobili (safra yolları içinde hava) ve stent görülebilir; metalik çizgi artefaktı stent lümeninin doğrudan değerlendirilmesini kısıtlayabilir.

Arteriyel

Rutin stent komplikasyonu taraması için gerekli değildir; eşlik eden aktif kanama veya psödoanevrizma düşünülüyorsa arteriyel fazda kontrast ekstravazasyonu ve arter bağlantısı aranır.

Önerilen pencereler: Batın (G 400 / M 50), Karaciğer (G 150 / M 30), Anjiyo (G 600 / M 150).

BT bulguları

• Stentin proksimal ucunun hedeflenen hepatik kanal/hilus düzeyine göre yer değiştirmesi veya distal ucun koledok-duodenum konumunun değişmesi.
• Metal ve plastik stentlerin yer değiştirmesi veya anatomiden kayması, özellikle bağırsak veya ampulla düzeyinde izlenebilir.
• Stentin proksimalinde yeni veya artan intrahepatik kanal genişlemesi ve dilate kanallarda dolum defektleri veya slaj birikimi gözlenir.
• Stentlerde sludge veya gıda birikimi tekrarlayan biliyer obstrüksiyonla ilişkili olabilir.
• Perkütan biliyer girişimler sonrası intrahepatik veya perihepatik hematom gelişebilir.
• Stent ucunun duodenum ya da bağırsak duvarını aşması, duvar kalınlaşması ve çevre ekstraluminal hava ile perforasyon.
• Arteriyel fazda stent güzergâhında psödoanevrizma veya kontrast ekstravazasyonu; eşlik eden hematom/hemoperitoneum.

Normalde

Komplikasyonsuz stent izleminde üst taraf safra yolu dilatasyonu veya intrahepatik koleksiyon saptanmayabilir. Takip BT'sinde proksimal biliyer kanal dilatasyonu ve intrahepatik sıvı koleksiyonları değerlendirilebilir.

Ayırıcı tanı

Biliyer stent açıklığı korunmuş hastada pnömobili görülebilir; tek başına hava varlığı stent oklüzyonunu göstermez.

Stent içinde sludge veya gıda birikimi ve stentolit oluşumu tekrarlayan biliyer obstrüksiyonla ilişkili olabilir.

Stent migrasyonu bağırsak perforasyonuna yol açabilir; BT'de stent ve perforasyona eşlik eden ekstraluminal gaz görülebilir.

Tuzaklar

• Metal stentlerde BT'deki metalik çizgi artefaktı, stentin iç lümeninin doğrudan görüntülenmesini kısıtlayabilir.
• Biliyer stent açıklığı korunmuş hastada pnömobili görülebilir; yalnızca hava varlığını stent oklüzyonu olarak yorumlama.
• Migrasyon geçirmiş plastik biliyer stent, BT'de ince bağırsakta radyoopak yabancı cisim olarak izlenebilir.
• Migrasyon geçirmiş biliyer stent bağırsak perforasyonuna yol açabilir; BT'de stentle birlikte bağırsak duvarı kalınlaşması ve ekstraluminal gaz görülebilir.

Kendini dene

1. Biliyer stenti bulunan hastada yeni sarılık var; stentin proksimalinde kanal genişlemesi ve lümen içinde yoğun debris izleniyor. En olası komplikasyon nedir?

   • Stent oklüzyonu
   • Stent migrasyonu
   • Safra yolu perforasyonu
   • Psödoanevrizma
   Cevabı göster

   Stent oklüzyonu. Üst taraf safra yolu genişlemesi ve stent içi debris tıkanma kuşkusunu destekler. Migrasyon için uçların konum değişikliği, perforasyon için duvar geçişi/ekstraluminal hava, psödoanevrizma için arteriyel kontrastlanan kese beklenir.

2. Biliyer stent migrasyonu şüphesi olan hastada BT'de duodenum perforasyonu saptanıyor. Bu bulgu hangi stent komplikasyonuyla uyumludur?

   • Stent migrasyonuna bağlı duodenum perforasyonu
   • Stent oklüzyonu
   • Stent enkrustasyonu
   • Stent kırılması
   Cevabı göster

   Stent migrasyonuna bağlı duodenum perforasyonu. BT'de biliyer stent migrasyonu ve duodenum perforasyonu birlikte gösterilebilir; bu görünüm migrasyona bağlı perforasyonla uyumludur.

İlgili konular

• Akut kolanjit
• Kolesistektomi sonrası beklenen görünüm ve komplikasyon ipuçları

Kaynaklar

Bu sayfadaki 35 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 10 cümle bu karşılaştırmada düzeltildi (2026-10-09).

1. Delayed-onset pancreatitis secondary to migration of a fully covered self-expanding metal biliary stent: a case reportpmc.ncbi.nlm.nih.gov
2. Iatrogenic portobiliary fistula treated with covered stent following percutaneous transhepatic biliary drainagepmc.ncbi.nlm.nih.gov
3. The stent that time forgot: perforated small bowel diverticulitis seventy years in the making, a case reportpmc.ncbi.nlm.nih.gov
4. Vascular complications in percutaneous biliary interventionspmc.ncbi.nlm.nih.gov
5. Beyond appearances: Complex endoscopic rescue therapy in a case of dual malignancypmc.ncbi.nlm.nih.gov
6. American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis.pubmed.ncbi.nlm.nih.gov
7. Complications of pancreato-duodenectomy.pubmed.ncbi.nlm.nih.gov
8. Role of endoscopic retrograde cholangiopancreatography in pancreatic diseases.pubmed.ncbi.nlm.nih.gov
9. Optimal treatments for hepato-pancreato-biliary trauma in severely injured patients: a narrative scoping review.pubmed.ncbi.nlm.nih.gov
10. Imaging of the porta hepatis: spectrum of disease.pubmed.ncbi.nlm.nih.gov
11. Non-surgical and non-chemical attempts to treat echinococcosis: do they work?pubmed.ncbi.nlm.nih.gov
12. Ultrasound of Biliary Cast Syndrome and Its Mimics.pubmed.ncbi.nlm.nih.gov
13. Whipple Procedure: A Five-Year Clinical Experience in Tertiary Care Center.pubmed.ncbi.nlm.nih.gov
14. Benign Biliary Strictures: Diagnostic Evaluation and Approaches to Percutaneous Treatment.pubmed.ncbi.nlm.nih.gov
15. Transplant Hepatic Artery Stenosis: Endovascular Treatment and Complications.pubmed.ncbi.nlm.nih.gov
16. Open surgery for hepatic hydatid disease.pubmed.ncbi.nlm.nih.gov
17. Percutaneous trans-hepatic bilateral biliary stenting in Bismuth IV malignant obstruction.pubmed.ncbi.nlm.nih.gov
18. Imaging of inflammatory disease of the pancreas.pubmed.ncbi.nlm.nih.gov
19. Pancreaticoduodenectomy in a patient with intestinal malrotation and distal cholangiocarcinoma: a case report and review of the literature.pubmed.ncbi.nlm.nih.gov
20. Duodenal Perforation From Dislodged Prophylactic Pancreatic Stent Following ERCP for Hilar Cholangiocarcinoma: A Rare Adverse Event.pubmed.ncbi.nlm.nih.gov
21. Self-Inflicted Wound: Spontaneous Pancreatic Duct Stent Migration Into Hepatic Parenchyma.pubmed.ncbi.nlm.nih.gov
22. Clinical Outcomes of Reintervention After Endoscopic Ultrasound-Guided Hepaticogastrostomy Using a Partially Covered Self-Expandable Metal Stent.pubmed.ncbi.nlm.nih.gov
23. Prevention and Management of Endoscopic Retrograde Cholangiopancreatography-Related Perforation: A Guideline-Based Narrative Review.pubmed.ncbi.nlm.nih.gov
24. Long-Term Outcomes of Endoscopic Transpapillary Gallbladder Stenting for Symptomatic Cholelithiasis.pubmed.ncbi.nlm.nih.gov
25. Complications and expected imaging findings after endoscopic retrograde cholangiopancreatography.pubmed.ncbi.nlm.nih.gov
26. Endoscopic Ultrasound-Guided Gallbladder Drainage for Malignant Distal Biliary Obstruction: Current Evidence, Technical Considerations, and Future Directions.pubmed.ncbi.nlm.nih.gov
27. Case Report: A steroid-sparing mechanical management of IgG4-related sclerosing cholangitis mimicking cholangiocarcinoma.pubmed.ncbi.nlm.nih.gov
28. The application of gastrointestinal endoscopy in children: a narrative review.pubmed.ncbi.nlm.nih.gov
29. Complications of Percutaneous Biliary Procedures.pubmed.ncbi.nlm.nih.gov
30. Turkish Society of Gastroenterology: Pancreas Working Group, Acute Pancreatitis Committee Consensus Report.pubmed.ncbi.nlm.nih.gov
31. Boerhaave Syndrome Caused by Pancreatitis-Induced Gastric Outlet Obstruction: A Case Report.pubmed.ncbi.nlm.nih.gov
32. AEG-AESPANC-OPGE-SIED-SPG Ibero-Latin American Guidelines on Acute Pancreatitis (iLATAM-AP).pubmed.ncbi.nlm.nih.gov
33. Clinical, Radiological, and Endoscopic Features of Pancreatic Pseudocyst and Walled-Off Necrosis: How to Diagnose and How to Drain Them.pubmed.ncbi.nlm.nih.gov
34. Acalculous cholecystitis- an imaging and therapeutic update.pubmed.ncbi.nlm.nih.gov
35. Emergent Treatment of Acute Cholangitis and Acute Cholecystitis.pubmed.ncbi.nlm.nih.gov
36. Iatrogenic portobiliary fistula treated with covered stent following percutaneous transhepatic biliary drainage.pubmed.ncbi.nlm.nih.gov
37. Vascular complications in percutaneous biliary interventions.pubmed.ncbi.nlm.nih.gov
38. Endovascular Management of Hemobilia as a Complication of Percutaneous Biliary Drainage.pubmed.ncbi.nlm.nih.gov
39. When Current Severity Overrides Reassuring Findings: TG18-Guided Biliary Drainage in ERCP-Confirmed Purulent Cholangitis.pubmed.ncbi.nlm.nih.gov
40. A novel technique of spacer implantation and proton beam therapy for hilar cholangiocarcinoma: a case report.pubmed.ncbi.nlm.nih.gov
41. From Migration to Emergency: A Systematic Review of Acute Presentations Following Late Esophageal Stent Migration.pubmed.ncbi.nlm.nih.gov
42. Ruptured Pseudoaneurysm of Right Hepatic Artery as Immediate Complication of Lumen-Apposing Metal Stent Placement for Choledochoduodenostomy: A Case Report.pubmed.ncbi.nlm.nih.gov
43. Management of Recurrent Biliary Anastomotic Stricture After Pancreaticoduodenectomy Using a Bioabsorbable Stent: A Case Report.pubmed.ncbi.nlm.nih.gov
44. Secondary sclerosing cholangitis: contemporary etiologies, diagnostic pathways, and treatment strategies for clinicians: a narrative review.pubmed.ncbi.nlm.nih.gov
45. Multifocal autoimmune pancreatitis complicated by pancreatic insufficiency and segmental portal hypertension: A case report and review of the literature.pubmed.ncbi.nlm.nih.gov
46. A rare case of IgG4-related sclerosing cholangitis followed by rapid subsequent diagnosis of cholangiocarcinoma.pubmed.ncbi.nlm.nih.gov
47. Interventional Radiology in the Management of Primary Liver Malignancies.pubmed.ncbi.nlm.nih.gov
48. Comprehensive Imaging Insights into Post-Cholecystectomy Complications for Enhanced Clinical Practice.pubmed.ncbi.nlm.nih.gov
49. Cystic lesions and their mimics involving the intrahepatic bile ducts and peribiliary space: diagnosis, complications, and management.pubmed.ncbi.nlm.nih.gov
50. Role of Endoscopic Ultrasonography in Management of Pancreaticobiliary Cancers: Recent Trends and Advances.pubmed.ncbi.nlm.nih.gov
51. Jejunal Perforation Due to Internal Pancreatic Stents Following Pancreaticoduodenectomy: A Case Series and Technical Modification.pubmed.ncbi.nlm.nih.gov
52. Postinsertion iliac vein stent position and relationship to contralateral deep vein thrombosis after unilateral iliac vein stenting.pubmed.ncbi.nlm.nih.gov
53. Clinical Characteristics, ERCP Management, and Early Adverse Events Among Patients with Choledocholithiasis at a Romanian Tertiary Referral Center: A Retrospective Cohort.pubmed.ncbi.nlm.nih.gov
54. Case Report: Vascular abdominal pain in systemic sclerosis-chronic mesenteric ischemia from high-grade superior mesenteric artery stenosis with coexisting aortomesenteric narrowing.pubmed.ncbi.nlm.nih.gov
55. Multidisciplinary Management of Common Bile Duct Metastasis from Rectal Cancer: A Case Report of Long-Term Disease Control and Literature Review.pubmed.ncbi.nlm.nih.gov
56. Prospective Clinical Evaluation of a Novel Repositionable Plastic Stent for Endosonography-Guided Hepaticogastrostomy With or Without Antegrade Stenting (With Videos).pubmed.ncbi.nlm.nih.gov
57. Long-term palliation of combined malignant gastric outlet and biliary obstruction by using sequentially enteral stents and EUS-guided antegrade biliary and lumen-apposing gastrojejunal stents.pubmed.ncbi.nlm.nih.gov
58. Advances in functional coatings on biliary stents.pubmed.ncbi.nlm.nih.gov
59. Protecting organs-at-risk in cancer therapies through temporary organ displacement: a comprehensive review.pubmed.ncbi.nlm.nih.gov
60. Evaluating the Effectiveness of Yttrium-90 Glass Microspheres in the Treatment of Hepatocellular Carcinoma, Intrahepatic Cholangiocarcinoma, and Metastatic Colorectal Cancer in Practice: Protocol for the Prospective PROACTIF Phase IV Registry Study in France.pubmed.ncbi.nlm.nih.gov
61. Chronic Pancreatitis: Role of Endoscopic Procedures.pubmed.ncbi.nlm.nih.gov
62. Gallbladder mucinous cystic neoplasm: Diagnostic challenges and multimodality imaging correlation.pubmed.ncbi.nlm.nih.gov
63. The stent that time forgot: perforated small bowel diverticulitis seventy years in the making, a case report.pubmed.ncbi.nlm.nih.gov
64. A rare complication of biliary stent insertion: biliary stent migration causing jejunal perforation.pubmed.ncbi.nlm.nih.gov
65. Early Duodenal Perforation Due to Migrated Plastic Biliary Stent, Successfully Managed Endoscopically: A Case Report.pubmed.ncbi.nlm.nih.gov
66. Chronic abdominal pain secondary to portosystemic collateral vessels: A case report and review of etiologies.pubmed.ncbi.nlm.nih.gov
67. All About Multiparametric MRI Evaluation in Biliary Tree Complications After Liver Transplant.pubmed.ncbi.nlm.nih.gov
68. The Deadly Masquerade: Unveiling the Fatal Facade of the Great Imitator.pubmed.ncbi.nlm.nih.gov
69. Current diagnosis and treatment of benign biliary strictures after living donor liver transplantation.pubmed.ncbi.nlm.nih.gov
70. Long-term safety and effectiveness of the "OptEase" vena cava filter.pubmed.ncbi.nlm.nih.gov
71. An updated review of cystic hepatic lesions.pubmed.ncbi.nlm.nih.gov
72. Does laparoscopic surgery decrease the risk of atrial fibrillation after foregut surgery?pubmed.ncbi.nlm.nih.gov
73. Pre-Endoscopic Retrograde Cholangiopancreatography Cholangitis and Stent Outcomes in Malignant Distal Biliary Obstruction: A Multicenter Propensity Score-Matched Analysis.pubmed.ncbi.nlm.nih.gov
74. Choledochal Stenting for Treatment of Extrahepatic Biliary Obstruction in Dogs with Ruptured Gallbladder: 2 Cases.pubmed.ncbi.nlm.nih.gov
75. Coil Migration After Embolization of Hepatic Artery Pseudoaneurysm Due to Biliary Stent Erosion.pubmed.ncbi.nlm.nih.gov
76. Bloody Phenomenon: A Rare Case of Hemobilia From Cystic Artery Hemorrhage Following Percutaneous Cholecystostomy.pubmed.ncbi.nlm.nih.gov
77. Endoscopic Retrieval of a Migrated Biliary Stent Causing Duodenal Perforation in a Patient With Mirizzi Syndrome.pubmed.ncbi.nlm.nih.gov
78. Duodenal perforations secondary to a migrated biliary plastic stent successfully treated by endoscope: case-report and review of the literature.pubmed.ncbi.nlm.nih.gov
79. Diagnostic endoscopic ultrasonography: assessment of safety and prevention of complications.pubmed.ncbi.nlm.nih.gov
80. Migrated biliary stent causing Meckel's diverticulitis and ileal perforation: a rare cause of acute abdomen.pubmed.ncbi.nlm.nih.gov
81. Endoscopic use of a biodegradable biliary stent in the management of a complex bile duct injury.pubmed.ncbi.nlm.nih.gov
82. A modified stent-free Chen's U-suture technique in pediatric pancreaticojejunostomy: safety and efficacy.pubmed.ncbi.nlm.nih.gov
83. Narrative review of vascular iatrogenic trauma and endovascular treatment.pubmed.ncbi.nlm.nih.gov
84. Imaging diagnosis of Caroli-like disease with concurrent extrahepatic biliary obstruction in a young small-breed dog: case report.pubmed.ncbi.nlm.nih.gov
85. Immunoglobulin G4 (IgG4)-Related Disease With a Biphasic Clinical Course of Spontaneous Remission and Relapse: A Case Report of Diagnostic Reasoning.pubmed.ncbi.nlm.nih.gov
86. Photodynamic therapy combined with a radiation-emitting metallic stent for extrahepatic cholangiocarcinoma: a first-in-human case report.pubmed.ncbi.nlm.nih.gov
87. Metachronous cholangiocarcinoma following pancreaticoduodenectomy and the potential role of a migrated pancreaticojejunal stent: a case report and review of the literature.pubmed.ncbi.nlm.nih.gov
88. Optimizing Transarterial Chemoembolization in Hepatocellular Carcinoma: Current Strategies, Innovations, and Future Directions.pubmed.ncbi.nlm.nih.gov
89. Imaging assessment after pancreaticoduodenectomy: reconstruction techniques-normal findings and complications.pubmed.ncbi.nlm.nih.gov
90. Conservative Management for Postoperative Portal Vein Bleeding: A Case Report.pubmed.ncbi.nlm.nih.gov
91. Primary Sclerosing Cholangitis in an Elderly Female With Concomitant Gallstone Disease: A Diagnostic Challenge and Literature Review.pubmed.ncbi.nlm.nih.gov
92. ¹⁹²Ir brachytherapy combined with external beam radiotherapy and biliary stenting for unresectable hilar cholangiocarcinoma.pubmed.ncbi.nlm.nih.gov
93. Impact of Multimodal Oncological Therapy on Survival and Local Control in Unresectable Perihilar Cholangiocarcinoma.pubmed.ncbi.nlm.nih.gov
94. The Stent That Went Too Far: Ascending Colon Perforation Following Gastric Stent Migration.pubmed.ncbi.nlm.nih.gov
95. Percutaneous Interventional Procedures for Bile Duct Injuries.pubmed.ncbi.nlm.nih.gov
96. Risk Management in ERCP and Endoscopic Ultrasound.pubmed.ncbi.nlm.nih.gov
97. Endovascular and percutaneous embolization of hepatic artery pseudoaneurysm: Etiology, embolic agents and technical success, and experience from a single center.pubmed.ncbi.nlm.nih.gov
98. BILIARY SLUDGE-ASSOCIATED ACUTE PANCREATITIS: CLINICAL SPECTRUM, DIAGNOSIS, AND MANAGEMENT.pubmed.ncbi.nlm.nih.gov
99. Case Report: Unexpected LAMS obstruction following successful EUS-BD in a patient with pancreatic carcinoma.pubmed.ncbi.nlm.nih.gov
100. Cholangitis, Choledocholithiasis and a Cholecystocolonic Fistula: A Case Report on a Rare Triple Surgical Challenge.pubmed.ncbi.nlm.nih.gov
101. Cross-sectional imaging of common and unusual complications after endoscopic retrograde cholangiopancreatography.pubmed.ncbi.nlm.nih.gov
102. International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines.pubmed.ncbi.nlm.nih.gov
103. Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.pubmed.ncbi.nlm.nih.gov
104. Successful Endourological Management of Encrusted Metallic Ureteral Stents: A Case-Series of Three Patients.pubmed.ncbi.nlm.nih.gov
105. Biliary Injuries Repair Using Copolymeric Scaffold: A Systematic Review and In Vivo Experimental Study.pubmed.ncbi.nlm.nih.gov
106. Retrograde ureteral catheterization under local anesthesia for emergency drainage in patients with infection and hydronephrosis secondary to ureteral calculi: Experience from a tertiary care hospital.pubmed.ncbi.nlm.nih.gov
107. Retrograde migration of a fractured plastic biliary stent fragment after percutaneous displacement into the bowel in a patient with hepaticojejunostomy requiring repeat percutaneous retrieval.pubmed.ncbi.nlm.nih.gov
108. Pancreaticoduodenectomy for ampullary adenocarcinoma performed in a conflict-zone field hospital during an active armed conflict: a case report.pubmed.ncbi.nlm.nih.gov
109. Case Report: The cystic masquerade in type 1 Von Hippel-Lindau disease: coexisting clear cell renal cell carcinoma and an imaging-suspected pancreatic neuroendocrine tumor.pubmed.ncbi.nlm.nih.gov
110. A Common Language for Post-Transplant Anastomotic Biliary Strictures: Standardized Endoscopic Outcome Definitions and a Failure-Mode Roadmap.pubmed.ncbi.nlm.nih.gov
111. Manufacturing, Processing, and Characterization of Self-Expanding Metallic Stents: A Comprehensive Review.pubmed.ncbi.nlm.nih.gov
112. Post-operative complications of cholecystectomy: what the radiologist needs to know.pubmed.ncbi.nlm.nih.gov
113. Emphysematous conditions of the abdomen and pelvis: pearls and pitfalls.pubmed.ncbi.nlm.nih.gov
114. Risk factors for postoperative stone formation in pediatric choledochal cysts: a study of 457 cases.pubmed.ncbi.nlm.nih.gov
115. Long-Term Outcomes of Endoscopic Management of Patients with Symptomatic Portal Cavernoma Cholangiopathy with No Shuntable Veins for Surgery or Failed Surgery.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.