Temporary self-expandable metal stent placement for treatment of post-sphincterotomy bleeding

Shah, Janak N.; Marson, Fernando P.; Binmoeller, Kenneth F.

doi:10.1016/j.gie.2010.08.012

Cited by 72 publications

(46 citation statements)

References 17 publications

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“…In a recent report [26], five patients were treated with temporary FCSEMSs for difficult-to-control post-ES bleeding. The stent worked through mechanical tamponade of the bleeding site.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…The full coverage of the stent decreased the incidence of complications and made stent removal safer and easier [3,[24][25][26]. Although not approved by the Food and Drug Administration, temporary FCSEMS placement is an excellent option in a subgroup of patients with BBCs that do not respond to plastic stent placement or to the usual endoscopic therapies [3,[24][25][26]. However, recent papers using FCSEMSs in BBCs [3,[24][25][26] reported complications, including duodenal migration [24,26], bile duct ulcerations [25], de novo choledocholithiasis [25], strictures [3,25], and even periampullary adenoma [25].…”

mentioning

confidence: 99%

“…Although not approved by the Food and Drug Administration, temporary FCSEMS placement is an excellent option in a subgroup of patients with BBCs that do not respond to plastic stent placement or to the usual endoscopic therapies [3,[24][25][26]. However, recent papers using FCSEMSs in BBCs [3,[24][25][26] reported complications, including duodenal migration [24,26], bile duct ulcerations [25], de novo choledocholithiasis [25], strictures [3,25], and even periampullary adenoma [25]. Furthermore, optimal stenting duration has not been well studied, and long-term stent placement commonly occurs [3,19,25].…”

mentioning

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].…”

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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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“…In a recent report [26], five patients were treated with temporary FCSEMSs for difficult-to-control post-ES bleeding. The stent worked through mechanical tamponade of the bleeding site.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

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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ERCP complications

Anastassiades¹,

Wong²

2015

Gastrointestinal Emergencies

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Management of postendoscopic sphincterotomy bleeding with fully covered self‐expanding metal stent

Huang

Tsai

Chen

et al. 2019

Adv in Digestive Medicine

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Postendoscopic sphincterotomy (ES) bleeding is one of the most frequent complications following ES. Different endoscopic interventions are available to manage post‐ES bleeding. Recently, the temporary placement of fully covered self‐expanding metal stent (FCSEMS) to achieve a tamponade effect has been described in post‐ES bleeding not controlled by other measures. The aim of this article is to present our clinical experience with management of post‐ES bleeding using FCSEMS. This is a retrospective analysis of prospectively collected data involving six patients who received FCSEMS for post‐ES bleeding after failure of traditional endoscopic interventions between the period of January 2013 and December 2016. Success of hemostasis and development of complications were evaluated. Successful hemostasis was achieved in all patients although one patient required additional endoscopic intervention after stent deployment. Two cases of pancreatitis were observed. There was no stent migration encountered. Temporary placement of FCSEMS is a safe and effective method to achieve hemostasis in post‐ES bleeding when primary endoscopic interventions failed. However, we should be aware of possible pancreatitis complications.

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Temporary self-expandable metal stent placement for treatment of post-sphincterotomy bleeding

Cited by 72 publications

References 17 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

ERCP complications

Management of postendoscopic sphincterotomy bleeding with fully covered self‐expanding metal stent

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