Korean J Gastroenterol.  2013 Jul;62(1):49-54. 10.4166/kjg.2013.62.1.49.

Temporary Placement of Fully Covered Self-expandable Metal Stents in Benign Biliary Strictures

• Ryu CH
• Kim MH
• Lee SS
• Park DH
• Seo DW
• Lee SK

• KMID: 1711279
• DOI: http://doi.org/10.4166/kjg.2013.62.1.49

Abstract

BACKGROUND/AIMS
Benign biliary strictures (BBSs) have been endoscopically managed with plastic stent placement. However, data regarding fully covered self-expandable metal stents (FCSEMSs) in BBS patients remain scarce in Korea.
METHODS
Forty-one patients (21 men, 65.9%) with BBSs underwent FCSEMS placement between February 2007 and July 2010 in Asan Medical Center. Efficacy and safety were evaluated retrospectively. Patients were considered to have resolution if they showed evidence of stricture resolution on cholangiography and if an inflated retrieval balloon easily passed through the strictures at FCSEMS removal.
RESULTS
The mean FCSEMS placement time was 3.2 (1.9-6.2) months. Patients were followed for a mean of 10.2 (1.0-32.0) months after FCSEMS removal. The BBS resolution rate was confirmed in 38 of 41 (92.7%) patients who underwent FCSEMS removal. After FCSEMS removal, 6 of 38 (15.8%) patients experienced symptomatic recurrent stricture and repeat stenting was performed. When a breakdown by etiology of stricture was performed, 14 of 15 (93.3%) patients with chronic pancreatitis, 17 of 19 (89.5%) with gall stone-related disease, 4 of 4 (100%) with surgical procedures, and 2 of 2 (100%) with BBSs of other etiology had resolution at FCSEMS removal. Complications related to stent therapy occurred in 12 (29%) patients, including post-ERCP pancreatitis (n=4), proximal migration (n=3), distal migration (n=3), and occlusion (n=2).
CONCLUSIONS
Temporary FCSEMS placement in BBS patients offers a potential alternative to plastic stenting. However, because of the significant complications and modest resolution rates, the potential benefits and risks should be evaluated in further investigations.

Keyword

Bile duct disease; Stent

MeSH Terms

Adult
Aged
Bile Duct Diseases/*therapy
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis, Sclerosing/etiology
Constriction, Pathologic
Female
Gallstones/etiology
Humans
Male
Middle Aged
Pancreatitis/etiology
Retrospective Studies
*Stents/adverse effects
Time Factors

Reference

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