Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jun;4(3):403-12.
doi: 10.1177/2050640615606550. Epub 2015 Sep 24.

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

Ulriikka Chaput  1 , Ariane Vienne  1 , Etienne Audureau  2 , Paul Bauret  3 , Philippe Bichard  4 , Dimitri Coumaros  5 , Bertrand Napoléon  6 , Thierry Ponchon  7 , Jean-Christophe Duchmann  8 , René Laugier  9 , Hervé Lamouliatte  10 , Bruno Védrenne  11 , Marianne Gaudric  1 , Stanislas Chaussade  12 , Françoise Robin  13 , Sarah Leblanc  1 , Frédéric Prat  12
Affiliations

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

Ulriikka Chaput et al. United European Gastroenterol J. 2016 Jun.

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.

Keywords: Benign biliary strictures; FCSEMS; chronic pancreatitis; endoscopic retrograde cholangiopancreatography; liver transplantation; metal stents.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flow chart summarizing overall outcomes.
See this image and copyright information in PMC

References

    1. Costamagna G, Pandolfi M, Mutignani M, et al. Long-term results of endoscopic management of postoperative bile duct strictures with increasing numbers of stents. Gastrointest Endosc 2001; 54: 162–168. - PubMed
    1. Pasha SF, Harrison ME, Das A, et al. Endoscopic treatment of anastomotic biliary strictures after deceased donor liver transplantation: outcomes after maximal stent therapy. Gastrointest Endosc 2007; 66: 44–51. - PubMed
    1. Poley JW, Lekkerkerker MN, Metselaar HJ, et al. Clinical outcome of progressive stenting in patients with anastomotic strictures after orthotopic liver transplantation. Endoscopy 2013; 45: 567–570. - PubMed
    1. Mahajan A, Ho H, Sauer B, et al. Temporary placement of fully covered self-expandable metal stents in benign biliary strictures: midterm evaluation (with video). Gastrointest Endosc 2009; 70: 303–309. - PubMed
    1. Kahaleh M, Tokar J, Le T, et al. Removal of self-expandable metallic Wallstents. Gastrointest Endosc 2004; 60: 640–644. - PubMed