PMID- 24061590
OWN - NLM
STAT- MEDLINE
DCOM- 20140304
LR  - 20211021
IS  - 1573-2568 (Electronic)
IS  - 0163-2116 (Linking)
VI  - 59
IP  - 1
DP  - 2014 Jan
TI  - Endoscopic treatment of benign biliary strictures using covered self-expandable 
      metal stents (CSEMS).
PG  - 152-60
LID - 10.1007/s10620-013-2859-7 [doi]
AB  - BACKGROUND AND AIMS: Traditional endoscopic management of benign biliary 
      strictures (BBS) consists of placement of one or more plastic stents. Emerging 
      data support the use of covered self-expandable metal stents (CSEMS). We sought 
      to assess outcome of endoscopic temporary placement of CSEMS in patients with 
      BBS. METHODS: This was a retrospective study of CSEMS placement for BBS between 
      May 2005 and July 2012 from two tertiary care centers. A total of 145 patients 
      (81 males, median age 59 years) with BBS were identified; 73 of which were 
      classified as extrinsic and were caused by chronic pancreatitis, and 70 were 
      intrinsic. Main outcome measures were resolution of stricture and adverse events 
      (AEs) due to self-expandable metal stents (SEMS)-related therapy. RESULTS: Fully 
      covered and partially covered 8-10 mm diameter SEMS were placed and subsequently 
      removed in 121/125 (97 %) attempts in BBS (failure to remove four partially 
      covered stents). Stricture resolution occurred in 83/125 (66 %) patients after a 
      median stent duration of 26 weeks (median follow-up 90 weeks). Resolution of 
      extrinsic strictures was significantly lower compared to intrinsic strictures 
      (31/65, 48 % vs. 52/60, 87 %, p = 0.004) despite longer median stent duration (30 
      vs. 20 weeks). Thirty-seven AEs occurred in 25 patients (17 %), with 12 
      developing multiple AEs including cholangitis (n = 17), pancreatitis (n = 5), 
      proximal stent migration (n = 3), cholecystitis (n = 2), pain requiring SEMS 
      removal and/or hospitalization (n = 3), inability to remove (n = 4), and new 
      stricture formation (n = 3). CONCLUSIONS: Benign biliary strictures can be 
      effectively treated with CSEMS. Successful resolution of biliary strictures due 
      to extrinsic disease is seen significantly less often than those due to intrinsic 
      disease. Removal is successful in all patients with fully covered SEMS.
FAU - Irani, Shayan
AU  - Irani S
AD  - Department of Gastroenterology, Virginia Mason Medical Center, Seattle, WA, USA.
FAU - Baron, Todd H
AU  - Baron TH
FAU - Akbar, Ali
AU  - Akbar A
FAU - Lin, Otto S
AU  - Lin OS
FAU - Gluck, Michael
AU  - Gluck M
FAU - Gan, Ian
AU  - Gan I
FAU - Ross, Andrew S
AU  - Ross AS
FAU - Petersen, Bret T
AU  - Petersen BT
FAU - Topazian, Mark
AU  - Topazian M
FAU - Kozarek, Richard A
AU  - Kozarek RA
LA  - eng
PT  - Journal Article
DEP - 20130924
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
SB  - IM
MH  - Biliary Tract Diseases/*therapy
MH  - Constriction, Pathologic/therapy
MH  - Endoscopy, Digestive System
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prosthesis Implantation
MH  - Retrospective Studies
MH  - *Stents
EDAT- 2013/09/26 06:00
MHDA- 2014/03/05 06:00
CRDT- 2013/09/25 06:00
PHST- 2013/05/27 00:00 [received]
PHST- 2013/08/22 00:00 [accepted]
PHST- 2013/09/25 06:00 [entrez]
PHST- 2013/09/26 06:00 [pubmed]
PHST- 2014/03/05 06:00 [medline]
AID - 10.1007/s10620-013-2859-7 [doi]
PST - ppublish
SO  - Dig Dis Sci. 2014 Jan;59(1):152-60. doi: 10.1007/s10620-013-2859-7. Epub 2013 Sep 
      24.