Evaluation of the Feasibility and Effectiveness of Placement of Fully Covered Self-Expandable Metallic Stents via Various Insertion Routes for Benign Biliary Strictures

Autor: Ko Tomishima, Shigeto Ishii, Toshio Fujisawa, Muneo Ikemura, Mako Ushio, Sho Takahashi, Wataru Yamagata, Yusuke Takasaki, Akinori Suzuki, Koichi Ito, Keiichi Haga, Kazushige Ochiai, Osamu Nomura, Hiroaki Saito, Tomoyoshi Shibuya, Akihito Nagahara, Hiroyuki Isayama
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Journal of Clinical Medicine, Vol 10, Iss 11, p 2397 (2021)
Druh dokumentu: article
ISSN: 2077-0383
DOI: 10.3390/jcm10112397
Popis: Background and aims: The goals of the management of benign biliary stricture (BBS) are to relieve symptoms and resolve short-/long-term stricture. We performed fully covered self-expandable metallic stent (hereafter, FCSEMS) placement for BBS using various methods and investigated the treatment outcomes and adverse events (AEs). Methods: We retrospectively studied patients who underwent FCSEMS placement for refractory BBS through various approaches between January 2017 and February 2020. FCSEMS were placed for 6 months, and an additional FCSEMS was placed if the stricture had not improved. Technical success rate, stricture resolution rate, and AE were measured. Results: A total of 26 patients with BBSs that were difficult to manage with plastic stents were included. The mean overall follow-up period was 43.3 ± 30.7 months. The cause of stricture was postoperative (46%), inflammatory (31%), and chronic pancreatitis (23%). There were four insertion methods: endoscopic with duodenoscopy, with enteroscopy, EUS-guided transmural, and percutaneous transhepatic. The technical success rate was 100%, without any AE. Stricture resolution was obtained in 19 (83%) of 23 cases, except for three cases of death due to other causes. Stent migration and cholangitis occurred in 23% and 6.3%, respectively. Stent fracture occurred in two cases in which FCSEMSs were placed for more than 6 months (7.2 and 10.3 months). Conclusion: FCSEMS placement for refractory BBS via various insertion routes was feasible and effective. FCSEMSs should be exchanged every 6 months until stricture resolution because of stent durability. Further prospective study for confirmation is required, particularly regarding EUS-guided FCSEMS placement.
Databáze: Directory of Open Access Journals
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