PMID- 34071678 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210615 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 10 IP - 11 DP - 2021 May 28 TI - Evaluation of the Feasibility and Effectiveness of Placement of Fully Covered Self-Expandable Metallic Stents via Various Insertion Routes for Benign Biliary Strictures. LID - 10.3390/jcm10112397 [doi] LID - 2397 AB - BACKGROUND AND AIMS: The goals of the management of benign biliary stricture (BBS) are to relieve symptoms and resolve short-/long-term stricture. We performed fully covered self-expandable metallic stent (hereafter, FCSEMS) placement for BBS using various methods and investigated the treatment outcomes and adverse events (AEs). METHODS: We retrospectively studied patients who underwent FCSEMS placement for refractory BBS through various approaches between January 2017 and February 2020. FCSEMS were placed for 6 months, and an additional FCSEMS was placed if the stricture had not improved. Technical success rate, stricture resolution rate, and AE were measured. RESULTS: A total of 26 patients with BBSs that were difficult to manage with plastic stents were included. The mean overall follow-up period was 43.3 +/- 30.7 months. The cause of stricture was postoperative (46%), inflammatory (31%), and chronic pancreatitis (23%). There were four insertion methods: endoscopic with duodenoscopy, with enteroscopy, EUS-guided transmural, and percutaneous transhepatic. The technical success rate was 100%, without any AE. Stricture resolution was obtained in 19 (83%) of 23 cases, except for three cases of death due to other causes. Stent migration and cholangitis occurred in 23% and 6.3%, respectively. Stent fracture occurred in two cases in which FCSEMSs were placed for more than 6 months (7.2 and 10.3 months). CONCLUSION: FCSEMS placement for refractory BBS via various insertion routes was feasible and effective. FCSEMSs should be exchanged every 6 months until stricture resolution because of stent durability. Further prospective study for confirmation is required, particularly regarding EUS-guided FCSEMS placement. FAU - Tomishima, Ko AU - Tomishima K AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Ishii, Shigeto AU - Ishii S AUID- ORCID: 0000-0002-4151-7765 AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Fujisawa, Toshio AU - Fujisawa T AUID- ORCID: 0000-0001-7367-0767 AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Ikemura, Muneo AU - Ikemura M AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Ushio, Mako AU - Ushio M AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Takahashi, Sho AU - Takahashi S AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Yamagata, Wataru AU - Yamagata W AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Takasaki, Yusuke AU - Takasaki Y AUID- ORCID: 0000-0002-5036-4545 AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Suzuki, Akinori AU - Suzuki A AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Ito, Koichi AU - Ito K AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Haga, Keiichi AU - Haga K AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Ochiai, Kazushige AU - Ochiai K AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Nomura, Osamu AU - Nomura O AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Saito, Hiroaki AU - Saito H AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Shibuya, Tomoyoshi AU - Shibuya T AUID- ORCID: 0000-0003-3558-7123 AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Nagahara, Akihito AU - Nagahara A AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. FAU - Isayama, Hiroyuki AU - Isayama H AD - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. LA - eng PT - Journal Article DEP - 20210528 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC8198386 OTO - NOTNLM OT - benign biliary stricture OT - biliary stent OT - endoscopic treatment OT - fully covered self-expandable metallic stents OT - metal stent COIS- The authors declare no conflict of interest. EDAT- 2021/06/03 06:00 MHDA- 2021/06/03 06:01 PMCR- 2021/05/28 CRDT- 2021/06/02 01:32 PHST- 2021/04/22 00:00 [received] PHST- 2021/05/17 00:00 [revised] PHST- 2021/05/28 00:00 [accepted] PHST- 2021/06/02 01:32 [entrez] PHST- 2021/06/03 06:00 [pubmed] PHST- 2021/06/03 06:01 [medline] PHST- 2021/05/28 00:00 [pmc-release] AID - jcm10112397 [pii] AID - jcm-10-02397 [pii] AID - 10.3390/jcm10112397 [doi] PST - epublish SO - J Clin Med. 2021 May 28;10(11):2397. doi: 10.3390/jcm10112397.