Temporary placement of fully covered self‐expandable metal stents for the treatment of benign biliary strictures. Issue 3 (1st June 2016)

• Record Type: Journal Article
• Authors: Chaput, Ulriikka; Vienne, Ariane; Audureau, Etienne; Bauret, Paul; Bichard, Philippe; Coumaros, Dimitri; Napoléon, Bertrand; Ponchon, Thierry; Duchmann, Jean‐Christophe; Laugier, René; Lamouliatte, Hervé; Védrenne, Bruno; Gaudric, Marianne; Chaussade, Stanislas; Robin, Françoise; Leblanc, Sarah; Prat, Frédéric
• Is Part Of: United European Gastroenterology journal. Volume 4:Issue 3(2016:Jun.)
• Page Start: 403
• Page End: 412
• Publication Date: 2016-06-01
• Subjects: Benign biliary strictures -- metal stents -- chronic pancreatitis -- liver transplantation -- endoscopic retrograde cholangiopancreatography -- FCSEMS; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640615606550
• Languages: English
• ISSNs: 2050-6406

Abstract

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.