Endoscopic Treatment of Benign Biliary Strictures Using Covered Self-Expandable Metal Stents (CSEMS)

Abstract

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.

Chronic pancreatitis

“…Wagh et al [52] prospectively evaluated the efficacy of fully covered self-expandable metal stents as an alternative to plastic stenting in patients with biliary strictures, including those due to chronic pancreatitis. Similar findings were reported by Irani et al [53]. All of the failures were seen in patients with biliary strictures in the setting of chronic calcific pancreatitis.…”

Plastic stents or covered self-expandable metal stents for benign biliary strictures: same song, different verse?

“…Since that time, a large amount of retrospective clinical experience accrued using covered metal stents for a variety of benign biliary diseases in humans (2,3). These studies confirmed the animal studies showing that as long as the covering remained intact, the stents were removable.…”

An Update to Hepatobiliary Stents

“…84 Irani et al performed a retrospective study of 145 patients using cSEMS for the decompression of benign biliary strictures. 85 Stricture resolution occurred in 66% of the patients with stent duration of 26 weeks. Extrinsic strictures were treated successfully in 49% of cases, with an 87% success rate in patients with intrinsic strictures.…”

“…All cSEMS were able to be removed. 85 Mahajan et al used 10 mm fcSEMS with fins in 44 patients with benign biliary strictures. Resolution of the strictures was confirmed in 83% of patients, with a median post-removal follow-up of 3.8 months.…”