Multiple plastic stents versus covered metal stent for treatment of anastomotic biliary strictures after liver transplantation: a prospective, randomized, multicenter trial
Autor: | Leena Kylänpää, I. Parzanese, Andrea Tal, Paolo Cantù, Fabian Finkelmeier, Mireen Friedrich-Rust, Joerg G. Albert, V. Penndorf, Natalie Filmann, Alexander Dechêne, Stefan Zeuzem, Marianne Udd, Andreas A. Schnitzbauer |
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Přispěvatelé: | Department of Surgery, II kirurgian klinikka, University of Helsinki, Clinicum, HUS Abdominal Center |
Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_treatment Medizin Constriction Pathologic Liver transplantation THERAPY DISEASE law.invention 0302 clinical medicine Randomized controlled trial Bile Ducts Extrahepatic law Self-expandable metallic stent Clinical endpoint Prospective Studies Prospective cohort study Cholangiopancreatography Endoscopic Retrograde OUTCOMES COMPLICATIONS Cholestasis Anastomosis Surgical Gastroenterology Middle Aged ENDOSCOPIC TREATMENT Prosthesis Failure 3. Good health Treatment Outcome 030220 oncology & carcinogenesis Retreatment Female 030211 gastroenterology & hepatology Radiology Plastics Adult medicine.medical_specialty Self Expandable Metallic Stents STENOSIS 03 medical and health sciences Multicenter trial MANAGEMENT medicine Humans Radiology Nuclear Medicine and imaging Aged business.industry Stent 3126 Surgery anesthesiology intensive care radiology Liver Transplantation Surgery Clinical trial business |
Zdroj: | Gastrointestinal Endoscopy. 86:1038-1045 |
ISSN: | 0016-5107 |
Popis: | Background and Aims: Treatment of anastomotic biliary strictures (ABSs) after orthotopic liver transplantation by endoscopic insertion of multiple plastic stents (MPSs) is well established. The use of covered self-expandable metal stents (cSEMSs) for this indication is less investigated. Methods: In an open-label, multicenter, randomized trial, patients with confirmed ABSs were randomly assigned 1:1 to receive either an MPS or a cSEMS. The primary endpoint was the number of endoscopic interventions until ABS resolution. Secondary endpoints were frequency of adverse events, treatment success rates, and time to treatment success and recurrence of ABS during follow-up of at least 1 year. Results: Fifty-eight patients were included between 2012 and 2015, and 48 patients completed follow-up. Patients receiving MPS (n = 24) underwent a median of 4 (range, 3-12) endoscopic retrograde cholangiography examinations, whereas those in the cSEMS group (n = 24) underwent a median of 2 (range, 2-12) sessions until ABS resolution (P |
Databáze: | OpenAIRE |
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