Sems Placement With and Without Biliary Sphincterectomy in Patients With Malignant Biliary Obstruction

A Prospective, Randomized, Multicenter Study Comparing Sems Placement With and Without Biliary Sphincterectomy in Patients With Malignant Biliary Obstruction

Placement of biliary self expanding metal stent (SEMS) is indicated when malignant common bile duct obstruction is encountered [1]. Currently, there is still controversy regarding the use of endoscopic sphincterotomy (EST) before the placement of biliary stents [2-5].

The aim of this prospective randomized, multicenter study is to investigate the role of EST before fully covered SEMS placement in patients with neoplastic biliary obstruction.

• Inclusion criteria

  • Patients referred for endoscopic retrograde cholangiopancreatography
  • Malignant bile duct obstruction
  • Signed written informed consent
  • Age > 18

• Exclusion criteria

  • Inability to provide inform consent
  • Pregnancy or lactation
  • Suspected perforation of the GI tract
  • Anatomical alterations due to previous surgery (Billroth surgery)
  • Coagulation alterations