1. A US Multicenter Study of Safety and Efficacy of Fully Covered Self-Expandable Metallic Stents in Benign Extrahepatic Biliary Strictures.
- Author
-
Saxena, Payal, Diehl, David, Kumbhari, Vivek, Shieh, Frederick, Buscaglia, Jonathan, Sze, Wilson, Kapoor, Sumit, Komanduri, Srinadh, Nasr, John, Shin, Eun, Singh, Vikesh, Lennon, Anne, Kalloo, Anthony, Khashab, Mouen, Diehl, David L, Buscaglia, Jonathan M, Shin, Eun Ji, Lennon, Anne Marie, Kalloo, Anthony N, and Khashab, Mouen A
- Subjects
- *
BILE ducts , *COMPARATIVE studies , *CHOLESTASIS , *ENDOSCOPIC retrograde cholangiopancreatography , *RESEARCH methodology , *MEDICAL cooperation , *METALS , *PROSTHETICS , *COMPLICATIONS of prosthesis , *RESEARCH , *SURGICAL stents , *TIME , *DISEASE relapse , *EVALUATION research , *SPECIALTY hospitals , *TREATMENT effectiveness , *RETROSPECTIVE studies , *FOREIGN body migration , *MEDICAL device removal , *CHOLANGITIS , *MEDICAL drainage , *EQUIPMENT & supplies , *DIAGNOSIS , *THERAPEUTICS - Abstract
Background: Endoscopic therapy is considered first line for management of benign biliary strictures (BBSs). Placement of plastic stents has been effective but limited by their short-term patency and need for repeated procedures. Fully covered self-expandable metallic stents (FCSEMSs) offer longer-lasting biliary drainage without the need for frequent exchanges.Aims: The aim of this study was to assess the efficacy and safety of FCSEMS in patients with BBS.Methods: A retrospective review of all patients who underwent ERCP and FCSEMS placement at five tertiary referral US hospitals was performed. Stricture resolution and adverse events related to ERCP and/or stenting were recorded.Results: A total of 123 patients underwent FCSEMS placement for BBS and 112 underwent a subsequent follow-up ERCP. The mean age was 62 years (±15.6), and 57% were males. Stricture resolution occurred in 81% of patients after a mean of 1.2 stenting procedures (mean stent dwell time 24.4 ± 2.3 weeks), with a mean follow-up of 18.5 months. Stricture recurrence occurred in 5 patients, and 3 patients required surgery for treatment of refractory strictures. Stent migration (9.7%) was the most common complication, followed by stent occlusion (4.9%), cholangitis (4.1%), and pancreatitis (3.3%). There was one case of stent fracture during removal, and one stent could not be removed. There was one death due to cholangitis.Conclusions: Majority of BBS can be successfully managed with 1-2 consecutive FCSEMS with stent dwell time of 6 months. [ABSTRACT FROM AUTHOR]- Published
- 2015
- Full Text
- View/download PDF