Temporary placement of fully covered self-expandable metal stents for the treatment of benign biliary strictures.

Autor: Chaput U; Gastroenterology Department, Cochin Hospital, Paris, France., Vienne A; Gastroenterology Department, Cochin Hospital, Paris, France., Audureau E; Public Health Department, Henri Mondor Hospital, LIC EA4393 Paris Est Créteil University (UPEC), Paris, France., Bauret P; Gastroenterology Department, Saint Eloi Hospital, Montpellier, France., Bichard P; Gastroenterology Department, La Tronche Hospital, Grenoble, France., Coumaros D; Gastroenterology Department, Civil Hospital of Strasbourg, Strasbourg, France., Napoléon B; Gastroenterology Department, Private Hospital Jean Mermoz, Lyon, France., Ponchon T; Gastroenterology Department, Edouard Herriot Hospital, Lyon, France., Duchmann JC; Gastroenterology Department, Hospital of Compiègne, Compiègne, France., Laugier R; Gastroenterology Department, La Timone Hospital, Marseille, France., Lamouliatte H; Gastroenterology Department, Saint-André Hospital, Bordeaux, France., Védrenne B; Gastroenterology Department, Emile Muller Hospital, Mulhouse, France., Gaudric M; Gastroenterology Department, Cochin Hospital, Paris, France., Chaussade S; Gastroenterology Department, Cochin Hospital, Paris, France; Paris-Descartes University, Paris, France., Robin F; French Society of Digestive Endoscopy, Lyon and Paris, France., Leblanc S; Gastroenterology Department, Cochin Hospital, Paris, France., Prat F; Gastroenterology Department, Cochin Hospital, Paris, France; Paris-Descartes University, Paris, France.
Jazyk: angličtina
Zdroj: United European gastroenterology journal [United European Gastroenterol J] 2016 Jun; Vol. 4 (3), pp. 403-12. Date of Electronic Publication: 2015 Sep 24.
DOI: 10.1177/2050640615606550
Abstrakt: 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.
Databáze: MEDLINE
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