repeat stenting risks

[Sarsi]

Hi All,

I have a question....I have a diagnosis of sphincter of oddi dysfunction and suffer from biliary pain and issues daily.

For the past few months, I have had a stent placed which has given almost total relief of all of these symptoms and pain.
This is my 2nd stent, and I have had 4 ercp's (including sphincterotomy)

My question is: what are the long-term risks of continued ercp's and damage to the duct/sphincter from getting these stents placed?

Thanks in advance for your thoughts and advice

Sarsi

[Sarsi]

Dear Dr Watters,

I have a further question if you don't mind me asking this of you....

On my ercp notes, it is mentioned that the sphincterotomy I have had previously is still open...

As such, would a sphincteroplasty actually be beneficial, or does this lend to the fact that the bile duct itself is the cause of my pain and symptoms?

I appreciate any wisdom that you could shed as I am confused at the moment...

kind Regards

Sarsi

[Christopher R Watters, MD]

The stents are fine until a permanent solution is decided on. With this said, if a surgical procedure is planned, the sooner the better.

If I could vote, I would favor the sphincteroplasty. This directly addresses the problem and allows for improved drainage of the pancreatic duct as well.

[Sarsi]

Thankyou for responding Dr Watters,

Yes, I have had a sphincterotomy previously, which only gave a few weeks relief....

I am looking at surgical options next year such as a transduodenal sphincteroplasty or choledochoduodenostomy.....depending on what my Drs/surgeons decide is the cause of my issues, the bile duct or sphincter or even both.....

I can't keep having these stents in the meantime.....or can I?

[Christopher R Watters, MD]

Stents are best considered temporary. They have been used as a predictive measure or sphinterotomy or formal sphincteroplasty. The problem is that there are problems with tents such as displacement or occlusion with resulting cholangitis. If stents have been placed have you previously had a sphincterotomy?