PMID- 19523620
OWN - NLM
STAT- MEDLINE
DCOM- 20091002
LR  - 20090727
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 70
IP  - 2
DP  - 2009 Aug
TI  - Temporary placement of fully covered self-expandable metal stents in benign 
      biliary strictures: midterm evaluation (with video).
PG  - 303-9
LID - 10.1016/j.gie.2008.11.029 [doi]
AB  - BACKGROUND: Benign biliary strictures (BBS) have been endoscopically managed with 
      placement of multiple plastic stents. Uncovered metal stents have been associated 
      with mucosal hyperplasia and partially covered self-expandable metal stents with 
      migration. Recently, fully covered self-expandable metal stents (CSEMSs) with 
      anchoring fins have become available. OBJECTIVE: Our purpose was to analyze the 
      efficacy and complication rates of CSEMSs in the treatment of BBS. DESIGN: CSEMSs 
      (10-mm diameter) were placed in 44 patients with BBS. CSEMSs were left in place 
      until adequate biliary drainage was achieved, confirmed by resolution of 
      symptoms, normalization of liver function tests, and imaging. SETTING: Tertiary 
      care center with long-standing experience with metal stents. PATIENTS: A total of 
      44 patients with BBS (28 men, median age 53.5 years) were included. The 
      preprocedure diagnoses included chronic pancreatitis (n = 19), gallstone-related 
      strictures (n = 14), post liver transplant (n = 9), autoimmune pancreatitis (n = 
      1), and primary sclerosing cholangitis (n = 1). INTERVENTION: ERCP with temporary 
      CSEMS placement. Removal of CSEMSs was performed with a snare or rat tooth. MAIN 
      OUTCOME MEASUREMENTS: Stricture resolution and morbidity. RESULTS: The median 
      time of CSEMS placement was 3.3 months (interquartile range 3.0-4.8). Resolution 
      of the BBS was confirmed in 34 of 41 patients (83%) after a median postremoval 
      follow-up time of 3.8 months (interquartile range 1.2-7.7). Complications were 
      observed in 6 (14%) patients after CSEMS placement and in 4 (9%) after CSEMS 
      removal. LIMITATION: Pilot study from a single center. CONCLUSION: Temporary 
      placement of CSEMSs for BBS may offer an alternative to plastic stenting. Further 
      investigation is required to further assess safety and long-term efficacy.
FAU - Mahajan, Anshu
AU  - Mahajan A
AD  - Digestive Health Center, University of Virginia Health System, Charlottesville, 
      Virginia 22908-0708, USA.
FAU - Ho, Henry
AU  - Ho H
FAU - Sauer, Bryan
AU  - Sauer B
FAU - Phillips, Melissa S
AU  - Phillips MS
FAU - Shami, Vanessa M
AU  - Shami VM
FAU - Ellen, Kristi
AU  - Ellen K
FAU - Rehan, Michele
AU  - Rehan M
FAU - Schmitt, Timothy M
AU  - Schmitt TM
FAU - Kahaleh, Michel
AU  - Kahaleh M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090611
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Cholestasis/*surgery
MH  - Constriction, Pathologic
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prosthesis Design
MH  - *Stents
MH  - Time Factors
MH  - Video Recording
EDAT- 2009/06/16 09:00
MHDA- 2009/10/03 06:00
CRDT- 2009/06/16 09:00
PHST- 2008/09/10 00:00 [received]
PHST- 2008/11/12 00:00 [accepted]
PHST- 2009/06/16 09:00 [entrez]
PHST- 2009/06/16 09:00 [pubmed]
PHST- 2009/10/03 06:00 [medline]
AID - S0016-5107(08)02951-9 [pii]
AID - 10.1016/j.gie.2008.11.029 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2009 Aug;70(2):303-9. doi: 10.1016/j.gie.2008.11.029. Epub 
      2009 Jun 11.