PMID- 21872710
OWN - NLM
STAT- MEDLINE
DCOM- 20120130
LR  - 20220408
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 74
IP  - 3
DP  - 2011 Sep
TI  - Complex biliary stones: treatment with removable self-expandable metal stents: a 
      new approach (with videos).
PG  - 520-6
LID - 10.1016/j.gie.2011.05.026 [doi]
AB  - BACKGROUND: Complex biliary stones often require temporary stent placement before 
      a repeat attempt at extraction. To date, covered self-expandable metal stents 
      (CSEMSs) have not been formally investigated for this indication. OBJECTIVE: To 
      evaluate the efficacy and safety of CSEMSs in patients with retained complex 
      biliary stones. DESIGN: Retrospective case series. SETTING: Large quaternary-care 
      center. PATIENTS: Thirty-six patients (24 women) with complex biliary stones with 
      incomplete stone clearance after endoscopic retrograde cholangiography (ERC) with 
      biliary sphincterotomy. INTERVENTIONS: Patients with incomplete stone clearance 
      after ERC with biliary sphincterotomy underwent temporary placement of CSEMSs, 
      with subsequent removal before repeat stone extraction. MAIN OUTCOME 
      MEASUREMENTS: Success achieving immediate biliary drainage and eventual complete 
      duct clearance. Procedure-related complications were also assessed. RESULTS: 
      CSEMS placement was successful in establishing immediate biliary drainage in all 
      36 patients. Complete duct clearance at repeat ERC was achieved in 29 of 35 
      patients after a mean duration of 6.4 weeks. Four of the remaining 6 patients 
      underwent sequential CSEMS placement, with eventual duct clearance after multiple 
      ERCPs. There were no complications related to biliary obstruction. One patient 
      died of a nonbiliary cause. Of the total 42 CSEMSs placed, there were 4 cases 
      (9.5%) of clinically insignificant stent migration. LIMITATIONS: Single-center 
      experience, retrospective design. CONCLUSIONS: CSEMSs permit management of 
      complex biliary stones, but require multiple sessions. The cost-effectiveness of 
      this technique needs further investigation.
CI  - Copyright (c) 2011 American Society for Gastrointestinal Endoscopy. Published by 
      Mosby, Inc. All rights reserved.
FAU - Cerefice, Mark
AU  - Cerefice M
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New 
      York, New York 10021, USA.
FAU - Sauer, Bryan
AU  - Sauer B
FAU - Javaid, Muhammad
AU  - Javaid M
FAU - Smith, LaVone A
AU  - Smith LA
FAU - Gosain, Sonia
AU  - Gosain S
FAU - Argo, Curtis K
AU  - Argo CK
FAU - Kahaleh, Michel
AU  - Kahaleh M
LA  - eng
PT  - Journal Article
PT  - Video-Audio Media
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
RN  - 0 (Coated Materials, Biocompatible)
SB  - IM
CIN - Gastrointest Endosc. 2012 Mar;75(3):696; author reply 696-7. PMID: 22341120
MH  - Aged
MH  - Aged, 80 and over
MH  - Cholangiopancreatography, Endoscopic Retrograde
MH  - Cholestasis/etiology/*therapy
MH  - Coated Materials, Biocompatible
MH  - Device Removal
MH  - Drainage/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Gallstones/complications/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prosthesis Failure/etiology
MH  - Retrospective Studies
MH  - Sphincterotomy, Endoscopic
MH  - *Stents/adverse effects
EDAT- 2011/08/30 06:00
MHDA- 2012/01/31 06:00
CRDT- 2011/08/30 06:00
PHST- 2011/03/01 00:00 [received]
PHST- 2011/05/17 00:00 [accepted]
PHST- 2011/08/30 06:00 [entrez]
PHST- 2011/08/30 06:00 [pubmed]
PHST- 2012/01/31 06:00 [medline]
AID - S0016-5107(11)01701-9 [pii]
AID - 10.1016/j.gie.2011.05.026 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2011 Sep;74(3):520-6. doi: 10.1016/j.gie.2011.05.026.