SAGES Magazine

THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2022 | VOLUME 20 | ISSUE 3 | 60 ERCP | A GUIDE FOR NURSES AND ASSISTANTS | Re-printed with permission The only 7Fr stents I use are double pigtail stents. The ones I use are 7 or 9cm long. (There are shorter ones which are used to drain pancreatic pseudocysts). Their main purpose is to hold stones up inside the bile duct as mentioned above. They can be used to place inside metals stents to prevent stones from getting lodged in them, or to prevent inward migration of removable metal stents. Double pigtail stents are loaded onto the guide wire using a black plastic cuff which is slid along the stent to straighten out the curves at the same time as the wire is pushed inside it. This is a fiddly procedure in itself and takes some practice. 10Fr stents come in lengths of 5, 7, 9, 12 and 15cm. As mentioned these are used to drain bile and the length of the stent depends on how far the stricture is from the ampulla. They have a barb at both ends, the distal end (or the one that goes into the duct first) is slightly tapered and the barb at that end is there to prevent the stent from falling out. At the other (proximal) end is another barb that prevents the stent from migrating into the duct. These are loaded onto a stent introduction system as shown here, making sure that the stent is the right way round (tapered tip first). The black catheter is slid along the wire which lies across the stricture, and the stent and white pushing catheter are pushed into the operating channel using the protective sleeve to prevent the proximal barb from being bent backwards. Once the black sleeve is advanced far enough (you can see the metal band a few cm behind the tip of the catheter the Xray image) then the black catheter is unlocked and held tightly with a bit of tension on it (make sure you don’t pull it out) so the white introducing catheter can be advanced, thus pushing the stent across the stricture. Once in place the wire is pulled back so the tip comes out of the black catheter, and can actually be left in place if a second stent is desired, and then the black catheter is removed from inside the white introducer until the stent is deployed (with a satisfying gush of bile on the screen!) 3 4 5 Fr Length cm Cotton-L Used to dr Order Number Reference Part Number Stent Size Fr G22383 CLSO-5-3 5 G21565 CLSO-5-5 5 G22384 CLSO-5-7 5 G22385 CLSO-5-9 5 G22398 CLSO-5-12 5 G22399 CLSO-5-15 5 G22392 CLSO-7-2 7 G21679 CLSO-7-3 7 G21680 CLSO-7-4 7 G21681 CLSO-7-5 7 G27143 CLSO-7-6 7 G21683 CLSO-7-7 7 G21684 CLSO-7-8 7 G21685 CLSO-7-9 7 G21979 CLSO-7-10 7 G21981 CLSO-7-11 7 G21983 CLSO-7-12 7 G21984 CLSO-7-13 7 G21987 CLSO-7-14 7 G21988 CLSO-7-15 7 Someproductsorpartnumbersmaynotbeavailable inallmarkets.Contactyour loc regarding:stock/non-stockstatus (expect longer lead time ifnon-stock),pricingand/ Includesapositioningsleeve. Seepage105,146,and106 for introducercomponents,soldseparately. Length cm 109 Biliary/Pancreatic - Plastic Stents Cook Medical Compass BDS™ Biliary Plastic Stent This device is used to drain obstructed biliary ducts. Order Number Reference Part Number Stent Size Fr Stent Length cm Wire Guide Diameter inch Minimum Accessory Channel mm G55519 CBSO-7-5 7 5 .035 2.8 G55520 CBSO-7-10 7 10 .035 2.8 G55521 CBSO-7-15 7 15 .035 2.8 Some products or part numbers may not be available in all markets. Contact your local Cook representative or Customer Service for details regarding: stock/non-stock status (expect longer lead time if non-stock), pricing and/or availability. Recomm nded for use with FS-PC-7 (pag 103) or PC-7 (page 106). Biliary/Pancreatic - Plastic Stents Fusion® OASIS® One Action Stent Introduction System Used for endoscopic biliary stent placement to drain obstructed bile ducts.