Management of benign biliary strictures with a novel retrievable self-expandable metal stent

Bing Hu, Joseph Leung, Dao Jian Gao, Tian Tian Wang, Jun Wu

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: Endoscopic placement of covered self-expandable metal stent (SEMS) has gained popularity in the management of benign biliary strictures (BBS). The existing SEMS has been designed primarily to palliate malignant biliary obstruction and has a high frequency of stent migration, difficulty in retrieval and stricture recurrence after stent removal. This study aimed to design a novel retrievable SEMS dedicated to the treatment of extrahepatic BBS and evaluate its clinical efficacy and safety. Methods: A short fully covered SEMS (FCSEMS) with a retrieval lasso was designed for the specific treatment of BBS. A total of 45 patients with segmental extrahepatic BBS were included in this study. The stent was placed entirely inside the bile duct with only the retrieval lasso extending from the papilla. The stents were recommended to be in situ for 6 to 12 months before removal. Results: The FCSEMS was successfully placed in all 45 patients. In all, 33 patients had their FCSEMS successfully removed after a mean period of 8.6 ± 3.7 (range 2-15.5) months. Stent migration occurred in 9.1% of the patients. During a mean follow-up of 18.9 months after stent removal, recurrent stricture was found in 2 (6.1%) patients and was successfully treated with a second FCSEMS. Overall, the strictures resolved in 30/33 (90.9%) patients. Conclusions: Intraductal placement of a short FCSEMS is suitable for the treatment of segmental extrahepatic BBS. This new removable design offered prolonged stenting and drainage for BBS for up to one year with minimal complications.

Original languageEnglish (US)
Pages (from-to)146-153
Number of pages8
JournalJournal of Digestive Diseases
Volume15
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Pathologic Constriction
Stents
Self Expandable Metallic Stents
Bile Ducts
Drainage
Therapeutics
Safety
Recurrence

Keywords

  • Benign biliary stricture
  • Biliary injury
  • ERCP
  • Liver transplantation
  • Self-expandable metal stent (SEMS)

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Management of benign biliary strictures with a novel retrievable self-expandable metal stent. / Hu, Bing; Leung, Joseph; Gao, Dao Jian; Wang, Tian Tian; Wu, Jun.

In: Journal of Digestive Diseases, Vol. 15, No. 3, 2014, p. 146-153.

Research output: Contribution to journalArticle

Hu, Bing ; Leung, Joseph ; Gao, Dao Jian ; Wang, Tian Tian ; Wu, Jun. / Management of benign biliary strictures with a novel retrievable self-expandable metal stent. In: Journal of Digestive Diseases. 2014 ; Vol. 15, No. 3. pp. 146-153.
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abstract = "Objective: Endoscopic placement of covered self-expandable metal stent (SEMS) has gained popularity in the management of benign biliary strictures (BBS). The existing SEMS has been designed primarily to palliate malignant biliary obstruction and has a high frequency of stent migration, difficulty in retrieval and stricture recurrence after stent removal. This study aimed to design a novel retrievable SEMS dedicated to the treatment of extrahepatic BBS and evaluate its clinical efficacy and safety. Methods: A short fully covered SEMS (FCSEMS) with a retrieval lasso was designed for the specific treatment of BBS. A total of 45 patients with segmental extrahepatic BBS were included in this study. The stent was placed entirely inside the bile duct with only the retrieval lasso extending from the papilla. The stents were recommended to be in situ for 6 to 12 months before removal. Results: The FCSEMS was successfully placed in all 45 patients. In all, 33 patients had their FCSEMS successfully removed after a mean period of 8.6 ± 3.7 (range 2-15.5) months. Stent migration occurred in 9.1{\%} of the patients. During a mean follow-up of 18.9 months after stent removal, recurrent stricture was found in 2 (6.1{\%}) patients and was successfully treated with a second FCSEMS. Overall, the strictures resolved in 30/33 (90.9{\%}) patients. Conclusions: Intraductal placement of a short FCSEMS is suitable for the treatment of segmental extrahepatic BBS. This new removable design offered prolonged stenting and drainage for BBS for up to one year with minimal complications.",
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