Treatment of Refractory Benign Biliary Stenoses in Liver Transplant Patients by Placement and Retrieval of a Temporary Stent-Graft: Work in Progress

Petersen, Bryan D.; Timmermans, Hans A.; Uchida, Barry T.; Rabkin, John M.; Keller, Frederick S.

doi:10.1016/s1051-0443(07)61812-0

Cited by 32 publications

(29 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, segmental ductal blockage by the covered stents did not cause a significant increase in serum bilirubin level or cholangitis [11]. They surmised that ductal blockage was not complete even when the stent fully expanded, and bile can flow through the space between the covering of the stent and the wall of the bile duct [10,27]. Although regular follow-up CT was not available in our study, the serum bilirubin level decreased significantly 1 week and 1 month after stent placement, regardless of segmental duct blockage.…”

Section: Discussionmentioning

confidence: 99%

Malignant Hilar Biliary Obstruction: Treatment by Means of Placement of a Newly Designed Y-Shaped Branched Covered Stent

Yun

Jung

Park

et al. 2015

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Malignant Hilar Biliary Obstruction: Treatment by Means of Placement of a Newly Designed Y-Shaped Branched Covered Stent

Yun

Jung

Park

et al. 2015

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

show abstract

“…However, stent migration occurred in 7 (24%) of 29 stents in the current study. Petersen et al 9 and Gwon et al 19 have also reported 11% and 21% of stent migration rates following percutaneous transhepatic covered biliary stent placement, respectively. The high rate of stent migration in our study might have been due to the short length of the stent, resulting in reduced ductal resistance against stent migration, and the relatively long duration of the stent placement.…”

Section: Discussionmentioning

confidence: 96%

“…Several investigators have reported their experiences using covered retrievable stents to treat biliary strictures occurring after orthotopic liver transplantation or LDLT. Petersen et al 9 reported a 100% successful removal rate of polytetrafluoroethylene-covered Z stents at a mean of 5.6 months after percutaneous transhepatic stent placement in 8 orthotopic liver transplant recipients. However, significant strictures recurred in 4 (50%) of the 8 lesions 5-6 months after stent removal.…”

Section: Discussionmentioning

confidence: 99%

“…Third, stent removal is relatively simple without the risk of causing major injuries to the biliary system because the stent could be completely collapsed and removed via a 9-Fr sheath by pulling on the stent drawstring with a retrieval hook wire. On the contrary, Petersen et al 9 removed their covered Z stents through 12-16 Fr sheaths and Kuo et al 10 through 10-12 Fr sheaths. However, there are several limitations to the use of retrievable covered stents to treat biliary anastomotic strictures following LDLT.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneously placed covered retrievable stents for the treatment of biliary anastomotic strictures following living donor liver transplantation

Kim

Sung

et al. 2010

Liver Transpl

View full text Add to dashboard Cite

This study evaluated the feasibility and efficacy of covered retrievable stent placement compared with drainage catheter placement for treating biliary anastomotic strictures following living donor liver transplantation (LDLT). In 39 of 59 patients who underwent LDLT, balloon dilation of strictures and subsequent interposition of 14-French indwelling catheters were performed (group 1), whereas in 20 patients, 29 covered retrievable stents were percutaneously placed (group 2). The drainage catheters were positioned above the stricture after at least 12 weeks of internal drainage or following stent removal after at least 8 weeks of stent placement. The drainage catheters were removed when the follow-up cholangiogram revealed free passage of contrast media. In the presence of residual stricture, either of the following was performed: (1) balloon dilation of the stricture and replacement of the indwelling catheter or (2) placement of another covered retrievable stent for at least 12 weeks. Technical success was achieved in all recipients. Clinical success was higher in group 1 (95%) than in group 2 (70%) (P ¼ 0.005), whereas the duration of treatment was significantly shorter in group 2 (197 6 89 days) than in group 1 (278 6 115 days) (P ¼ 0.018). All stents were successfully removed at a median of 14 weeks after placement, except for 1 patient in whom early stent removal was inevitable and a second patient in whom the stent migrated completely. Stent migration rate was 24% (7 of 29 stents). In conclusion, treatment of biliary anastomotic strictures following LDLT is feasible using covered retrievable stents and has an acceptable clinical success rate with shorter treatment duration. Liver Transpl

show abstract

“…At a mean of 28 months after removal of the stent-grafts, the patency rate was 97%. Stent-grafts also prevented the ingrowth of tissue and could be retrieved (32, 33). However, self-expanding stent-grafts are relatively long, making them difficult to place in a short anastomotic stricture.…”

Section: Discussionmentioning

confidence: 99%

Temporary Placement of Stent Grafts in Postsurgical Benign Biliary Strictures: a Single Center Experience

et al. 2011

View full text Add to dashboard Cite

ObjectiveTo evaluate the effect of temporary stent graft placement in the treatment of benign anastomotic biliary strictures.Materials and MethodsNine patients, five women and four men, 22-64 years old (mean, 47.5 years), with chronic benign biliary anastomotic strictures, refractory to repeated balloon dilations, were treated by prolonged, temporary placement of stent-grafts. Four patients had strictures following a liver transplantation; three of them in bilio-enteric anastomoses and one in a choledocho-choledochostomy. Four of the other five patients had strictures at bilio-enteric anastomoses, which developed after complications following laparoscopic cholecystectomies and in one after a Whipple procedure for duodenal carcinoma. In eight patients, balloon-expandable stent-grafts were placed and one patient was treated by insertion of a self-expanding stent-graft.ResultsIn the transplant group, treatment of patients with bilio-enteric anastomoses was unsuccessful (mean stent duration, 30 days). The patient treated for stenosis in the choledocho-choledochostomy responded well to consecutive self-expanding stent-graft placement (total placement duration, 112 days). All patients with bilio-enteric anastomoses in the non-transplant group were treated successfully with stent-grafts (mean placement duration, 37 days).ConclusionTreatment of benign biliary strictures with temporary placement of stent-grafts has a positive effect, but is less successful in patients with strictures developed following a liver transplant.

show abstract

Treatment of Refractory Benign Biliary Stenoses in Liver Transplant Patients by Placement and Retrieval of a Temporary Stent-Graft: Work in Progress

Cited by 32 publications

References 18 publications

Malignant Hilar Biliary Obstruction: Treatment by Means of Placement of a Newly Designed Y-Shaped Branched Covered Stent

Malignant Hilar Biliary Obstruction: Treatment by Means of Placement of a Newly Designed Y-Shaped Branched Covered Stent

Percutaneously placed covered retrievable stents for the treatment of biliary anastomotic strictures following living donor liver transplantation

Temporary Placement of Stent Grafts in Postsurgical Benign Biliary Strictures: a Single Center Experience

Contact Info

Product

Resources

About