PMID- 37162469
OWN - NLM
STAT- Publisher
LR  - 20230510
IS  - 2724-5365 (Electronic)
IS  - 2724-5985 (Linking)
DP  - 2023 May 10
TI  - Management of biliary complications in liver transplant recipients using a fully 
      covered self-expandable metal stent with antimigration features.
LID - 10.23736/S2724-5985.23.03343-0 [doi]
AB  - BACKGROUND: Following liver transplant (LT) with duct-to-duct anastomosis, 
      biliary strictures and leaks are typically managed with endoscopic retrograde 
      cholangiopancreatography (ERCP) and stenting. While multiple side-by-side plastic 
      stents are typically used for management of anastomotic strictures, fully covered 
      self-expandable metal stents (FCSEMS) can be used to decrease the number of ERCPs 
      with longer periods of stent patency. The risk of migration can limit their use. 
      FCSEMS with antimigration fins to manage benign biliary complications following 
      LT may provide stricture resolution with limited adverse events (AEs). METHODS: 
      Single center retrospective study of LT patients who required FCSEMS from 1/2014 
      to 4/2022. Primary outcomes included stricture resolution and recurrence. 
      Secondary outcomes were stent migration, occlusion, removability, and number of 
      ERCPs. RESULTS: Forty-three patients (mean age 55.5 years) with anastomotic 
      strictures (N.=37), bile leaks (N.=4) or both (N.=2) were included. The median 
      time from LT to FCSEMS placement was 125 days. Within one year of LT, 31 patients 
      required intervention; early intervention at less than 30 and 90 days was needed 
      in 7 and 19 patients, respectively. The median length of follow up was 816.5 
      days. Stricture resolution was seen in 35 patients (81%) after a median stent 
      dwell time of 130.5 days; recurrence occurred in 8 patients. There were three 
      instances of partial stent migration that did not require reintervention or 
      interfere with removability. The mean number of ERCPs required was 2.5. 
      CONCLUSIONS: The use of a FCSEMS with antimigration features yields effective 
      stricture resolution with longer stent dwell times and fewer ERCPs.
FAU - Canakis, Andrew
AU  - Canakis A
AD  - Division of Gastroenterology and Hepatology, University of Maryland School of 
      Medicine, Baltimore, MD, USA.
FAU - Gilman, Andrew J
AU  - Gilman AJ
AD  - Division of Gastroenterology and Hepatology, University of North Carolina at 
      Chapel Hill, Chapel Hill, NC, USA.
FAU - Baron, Todd H
AU  - Baron TH
AD  - Division of Gastroenterology and Hepatology, University of North Carolina at 
      Chapel Hill, Chapel Hill, NC, USA - todd_baron@med.unc.edu.
LA  - eng
PT  - Journal Article
DEP - 20230510
PL  - Italy
TA  - Minerva Gastroenterol (Torino)
JT  - Minerva gastroenterology
JID - 101777280
SB  - IM
EDAT- 2023/05/10 12:42
MHDA- 2023/05/10 12:42
CRDT- 2023/05/10 10:36
PHST- 2023/05/10 12:42 [medline]
PHST- 2023/05/10 12:42 [pubmed]
PHST- 2023/05/10 10:36 [entrez]
AID - S2724-5985.23.03343-0 [pii]
AID - 10.23736/S2724-5985.23.03343-0 [doi]
PST - aheadofprint
SO  - Minerva Gastroenterol (Torino). 2023 May 10. doi: 10.23736/S2724-5985.23.03343-0.