Open AccessTemporary placement of fully covered self‐expandable metal stents for the treatment of benign biliary strictures
Author(s) -
Chaput Ulriikka,
Vienne Ariane,
Audureau Etienne,
Bauret Paul,
Bichard Philippe,
Coumaros Dimitri,
Napoléon Bertrand,
Ponchon Thierry,
Duchmann JeanChristophe,
Laugier René,
Lamouliatte Hervé,
Védrenne Bruno,
Gaudric Marianne,
Chaussade Stanislas,
Robin Françoise,
Leblanc Sarah,
Prat Frédéric
Publication year - 2016
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640615606550
Subject(s) - medicine , pancreatitis , endoscopic retrograde cholangiopancreatography , stent , surgery , anastomosis , liver transplantation , transplantation
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.