The Treatment of Patients with Symptomatic Common Bile Duct Stenosis Secondary to Chronic Pancreatitis Using Partially Covered Metal Stents: A Pilot Study

Cantù, P.; Hookey, Lawrence; Morales, April A.; Moine, Olivier Le; Devière, Jacques

doi:10.1055/s-2005-870130

Cited by 79 publications

(54 citation statements)

References 21 publications

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“…12 Biliary metal stents have recently been used to maintain ductal patency in patients with benign biliary strictures. [13][14][15] However, the use of an uncovered SEMS for benign biliary strictures is highly controversial because they are associated with epithelial hyperplasia, leading to chronic inflammation and becoming embedded in the bile duct wall. 15,16 Temporary placement of covered SEMSs for benign biliary strictures may offer an alternative to plastic stenting, but is associated with migration.…”

Section: Discussionmentioning

confidence: 99%

Temporary Placement of a Newly Designed, Fully Covered, Self-Expandable Metal Stent for Refractory Bile Leaks

Hwang¹,

Kim²,

Yoo³

et al. 2011

Gut Liver

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Bile leaks remain a signifi cant cause of morbidity for patients undergoing laparoscopic cholecystectomy. Leakage from an injured duct of Luschka (subvesical duct) follows the cystic duct as the most common cause of postcholecystectomy bile leaks. Although endoscopic sphincterotomy, plastic-stent placement, or nasobiliary-drain placement are effective in healing biliary leaks, in patients in whom leakage persists and the symptoms worsen despite conventional endoscopic treatment, re-exploration with laparoscopy and ligation of the injured subvesical duct should be considered. We present herein the case of a 31-year-old woman with refractory bile leakage from a disrupted subvesical duct after cholecystectomy that could not be managed with endoscopic sphincterotomy and plastic-stent placement. A newly designed, fully covered, self-expandable metal stent (FC-SEMS) was successfully placed for the treatment of refractory bile leaks in this patient. It appears that temporary placement of an FC-SEMS is technically feasible and provides an effective alternative to surgical therapy for refractory bile leaks after cholecystectomy. (Gut Liver 2011;5:96-99)

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Section: Discussionmentioning

confidence: 99%

Temporary Placement of a Newly Designed, Fully Covered, Self-Expandable Metal Stent for Refractory Bile Leaks

Hwang¹,

Kim²,

Yoo³

et al. 2011

Gut Liver

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“…More aggressive endoscopic therapy, by placement of multiple plastic stents, can obtain stricture resolution in 44−90% of cases with a 13-48 months follow-up period after stent removal [208][209][210]. Although the role of self-expandable metal stents is well established for malignant obstruction, their use in benign strictures including chronic pancreatitis is less clear and controversial [211][212][213]. Clogging or dysfunction of these stents is reported in 10−62% of the cases after a mean follow-up of 22-50 months.…”

Section: E3: Is Endoscopic Therapy Indicated In Chronic Pancreatitismentioning

confidence: 99%

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

165

112

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This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l

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“…This capacity, combined with the larger diameter of the covered metal stent makes stepwise dilation, as is performed with multiple plastic stents, unnecessary and may thus reduce the number of procedures (24). The clinical experience with covered metal stents for benign biliary strictures has until now been only limited (24,25). Covered metal stent placement for benign biliary strictures is still associated with relatively high complication rates (39.6%).…”

Section: Discussionmentioning

confidence: 99%

New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

Woo

Kim

Lee

et al. 2012

Korean J Transplant

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Background: In cases of endoscopic intervention treatment for biliary stricture which fail, a percutaneous approach can be subsequently attempted. However, the quality of life is lower for those patients with percutaneous transhepatic biliary drainage (PTBD) tubes than those with endoscopic retrograde biliary drainage tubes. In this study, we report the outcome of the application of percutaneous transhepatic biliary stenting (PTBS) for use in subsequent endoscopic treatment of biliary stricture after living donor liver transplantation (LDLT).Methods: Of 165 patients who underwent LDLT, 40 (24.2%) were diagnosed with anastomotic biliary strictures. Of these patients, seven agreed to treatment using PTBS using a plastic stent with endoscopic follow-up instead of treatment by insertion of a PTBD tube, and were enrolled in this study.Results: In all seven patients, the use of this technique enabled effective advancement of a guide wire and successful placement of one or two plastic stents (7 or 10 Fr) into the PTBD tract. There were no PTBS-related complications associated with the procedure. The median duration for stent use was 40.3 weeks (range; 27.6~65.0). Upon final removal of all stents, the stricture had been resolved in four (57%) of the seven patients.Conclusions: Our study data suggested that, after failed use of ERCP in the treatment of biliary stricture after LDLT, the use of PTBS and ERCP may be an effective and safe treatment.

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The Treatment of Patients with Symptomatic Common Bile Duct Stenosis Secondary to Chronic Pancreatitis Using Partially Covered Metal Stents: A Pilot Study

Cited by 79 publications

References 21 publications

Temporary Placement of a Newly Designed, Fully Covered, Self-Expandable Metal Stent for Refractory Bile Leaks

Temporary Placement of a Newly Designed, Fully Covered, Self-Expandable Metal Stent for Refractory Bile Leaks

Italian consensus guidelines for chronic pancreatitis

New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

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