Endoscopic stenting

Endoscopic stenting is a medical procedure used to open narrowed or blocked areas within the gastrointestinal (GI) tract, bile ducts, or other ducts within the body. This minimally invasive technique involves the placement of a stent, which is a tube-like device, to ensure the patency of a lumen or to relieve obstruction in the body's passageways. Endoscopic stenting is commonly performed by gastroenterologists or interventional radiologists.

Indications[edit | edit source]

Endoscopic stenting is indicated for various conditions, including but not limited to:

Esophageal cancer: To alleviate dysphagia (difficulty swallowing) caused by tumors.
Gastric cancer: To maintain gastric outlet patency.
Pancreatic cancer: For the relief of jaundice when the bile duct is obstructed.
Cholangiocarcinoma: To drain the biliary system.
Benign biliary strictures: Resulting from conditions such as chronic pancreatitis.
Colorectal cancer: To relieve obstruction in the colon.
Gastrointestinal strictures: Benign strictures that may result from surgical anastomoses, peptic ulcer disease, or inflammatory bowel disease.

Procedure[edit | edit source]

The procedure is typically performed under sedation or general anesthesia. It involves the use of an endoscope, a flexible tube with a light and camera at the end, which is inserted through the mouth or rectum, depending on the site that requires intervention. The process includes:

Diagnostic evaluation: To assess the location and extent of the obstruction or narrowing.
Stent placement: Guided by endoscopy and fluoroscopy, a stent is advanced to the site of obstruction and deployed to expand and maintain the opening of the lumen.

Types of Stents[edit | edit source]

Self-expanding metal stents (SEMS): Made of materials that expand after placement, providing immediate relief of obstruction.
Plastic stents: Less expensive but may have a higher rate of occlusion and require replacement more frequently.
Covered stents: Encased in a material that prevents tumor in-growth through the stent, potentially reducing the risk of occlusion.
Uncovered stents: Allow for ingrowth of tissue, which can help anchor the stent but may lead to occlusion.

Complications[edit | edit source]

While endoscopic stenting is generally safe, complications can occur, including:

Stent migration
Infection
Perforation of the GI tract
Bleeding
Stent occlusion

Aftercare[edit | edit source]

Post-procedure care focuses on monitoring for complications, managing pain, and ensuring proper nutrition. Patients may need follow-up endoscopies to assess stent function and to manage any complications.

Conclusion[edit | edit source]

Endoscopic stenting is a valuable procedure for managing obstructions in the gastrointestinal tract and other ducts within the body. It offers a less invasive alternative to surgery and can significantly improve the quality of life for patients with obstructive conditions.