Anchoring flap versus flared end, fully covered self-expandable metal stents to prevent migration in patients with benign biliary strictures: a multicenter, prospective, comparative pilot study (with videos)

Park, Do Hyun; Lee, Sang Soo; Lee, Tae Hoon; Ryu, Choong Heon; Kim, Hong Jun; Seo, Dong Wan; Park, Sang Heum; Lee, Sung Koo; Kim, Myung Hwan; Kim, Sun Joo

doi:10.1016/j.gie.2010.09.039

Cited by 153 publications

(141 citation statements)

References 31 publications

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“…Strictures were subsequently treated by multiple placements of plastic stents (not FCSEMS). Although reports exist suggesting that temporary FCSEMS placement in benign strictures offers a potential alternative to the multiple plastic stent strategy [21,24,27], these findings have been challenged in literature [30]. We treated seven patients with benign biliary strictures using FCSEMS (unpublished data), and we observed complications in six patients.…”

Section: Discussionmentioning

confidence: 92%

“…Although no studies are available on this matter, FCSEMS placement as a rescue therapy is likely to be cost-effective because the prevention of several procedures (including surgery) offsets the cost of the stents. Complications have been reported in papers using FCS-EMS to treat BBCs [3,[24][25][26][27]. One common complication is stent migration, which has been reported previously [24,26].…”

Section: Discussionmentioning

confidence: 96%

“…Late complications were defined as those complications that occurred after FCSEMS removal. Migration (distal or proximal), pancreatitis, cholecystitis, bile duct and duodenal ulcerations, de novo choledocholithiasis, and late strictures were carefully monitored using previously defined definitions [16,20,23,25,27].…”

Section: Definitionsmentioning

confidence: 99%

“…Furthermore, optimal stenting duration has not been well studied, and long-term stent placement commonly occurs [3,19,25]. Prolonged FCSEMS placement is associated with the majority of the complications reported and has not been shown to increase efficacy [3,25,26], except in the treatment of strictures [3,24,27].…”

mentioning

confidence: 99%

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Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Canena

Liberato²,

Horta

et al. 2012

Surg Endosc

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Background Fully covered self-expandable metal stents (FCSEMS) have been used as a rescue therapy for several benign biliary tract conditions (BBC). Long-term stent placement commonly occurs, and prolonged FCSEMS placement is associated with the majority of the complications reported. This study evaluated the duration of stenting and the efficacy and safety of temporary FCSEMS placement for three BBCs: refractory biliary leaks, postsphincterotomy bleeding, and perforations. Methods This was a retrospective case series with longterm follow-up of 25 patients who underwent FCSEMS placement for BBCs. This study included 17 patients with postcholecystectomy refractory biliary leaks who had previously undergone unsuccessful sphincterotomy and plastic stent placement, 4 patients with difficult-to-control postsphincterotomy bleeding, and 4 patients with a perforation following endoscopic sphincterotomy. Stents were removed according to clinical evidence of problem resolution. The review included stenting duration, safe FCSEMS removal, clinical efficacy, complications, and long-term outcomes. During the follow-up period, ERCP and cholangioscopy procedures were performed to exclude the possibility of bile duct lesion development. Results Complete resolution of the initial condition was achieved in all patients. Patients with biliary leaks had a median stent duration time of 16 days (range 7-28 days). Patients with bleeding had stents removed after a median time of 6 days (range 3-15 days). Patients with perforations had their stents removed after a median time of 29.5 days (range 21-30 days). There were no complications related to stenting. Conclusions Temporary placement of a FCSEMS for 30 days or less is an effective rescue therapy for refractory biliary leaks, difficult-to-control post-endoscopic sphincterotomy bleeding, and perforations. Duration of stenting should be different for each type of condition. Stents can be safely removed, and short-term stenting is associated with the absence of early and late complications.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 96%

Section: Definitionsmentioning

confidence: 99%

mentioning

confidence: 99%

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Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Canena

Liberato²,

Horta

et al. 2012

Surg Endosc

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“…To prevent stent migration, anchoring flaps were recently created on the outer surfaces of SEMS (Fig. 7), 31 and different levels of segmental RF were created by wire-weaving different cell sizes for each segment over the whole length of the SEMS 32 ( Fig. 8).…”

Section: Specific and Dedicated Structure Of Semsmentioning

confidence: 99%

Spontaneous Common Bile Duct Perforation Treated with Placement of Metal Stent

Yang¹,

Moon²,

You³

et al. 2016

Korean J Pancreas Biliary Tract

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Biliary self-expandable metal stents (SEMS), a group of non-vascular stents, have been used in the palliative management of biliary obstruction around the world. However, there are still unmet needs in the clinical application of biliary SEMS. Comprehensive understanding of the SEMS is required to resolve the drawbacks and difficulties of metal stent development. The basic structure of SEMS, including the materials and knitting methods of metal wires, covering materials, and radiopaque markers, are discussed in this review. What we know about the physical and mechanical properties of the SEMS is very important. With an understanding of the basic knowledge of metal stents, hurdles such as stent occlusion, migration, and kinking can be overcome to develop more ideal SEMS.

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Benign Biliary Strictures

Cunningham

2014

Ercp

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Anchoring flap versus flared end, fully covered self-expandable metal stents to prevent migration in patients with benign biliary strictures: a multicenter, prospective, comparative pilot study (with videos)

Cited by 153 publications

References 31 publications

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Spontaneous Common Bile Duct Perforation Treated with Placement of Metal Stent

Benign Biliary Strictures

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