Temporary placement of fully covered self-expandable metal stents for the treatment of benign biliary strictures.
United European Gastroenterol J
; 4(3): 403-12, 2016 Jun.
Article
en En
| MEDLINE
| ID: mdl-27403307
ABSTRACT
BACKGROUND:
Endoscopic treatment of benign biliary strictures (BBS) can be challenging.OBJECTIVE:
To evaluate the efficacy of fully covered self-expandable metal stents (FCSEMS) in BBS.METHODS:
Ninety-two consecutive patients with BBS (chronic pancreatitis (n = 42), anastomotic after liver transplantation (n = 36), and post biliary surgical procedure (n = 14)) were included. FCSEMS were placed across strictures for 6 months before endoscopic extraction. Early success rate was defined as the absence of biliary stricture or as a minimal residual anomaly on post-stent removal endoscopic retrograde cholangiopancreatography (ERCP). Secondary outcomes were the final success and stricture recurrence rates as well as procedure-related morbidity.RESULTS:
Stenting was successful in all patients. Stenting associated complications were minor and occurred in 22 (23.9%) patients. Migration occurred in 23 (25%) patients. Stent extraction was successful in all but two patients with proximal stent migration. ERCP after the 6 months stenting showed an early success in 84.9% patients (chronic pancreatitis patients 94.7%, liver transplant 87.9%, post-surgical 61.5%) (p = 0.01). Final success was observed in 57/73 (78.1%) patients with a median follow-up of 12 ± 3.56 months. Recurrence of biliary stricture occurred in 16/73 (21.9%) patients.CONCLUSIONS:
FCSEMS placement is efficient for patients with BBS, in particular for chronic pancreatitis patients. Stent extraction after 6 months indwelling, although generally feasible, may fail in a few cases.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
United European Gastroenterol J
Año:
2016
Tipo del documento:
Article
País de afiliación:
Francia