Tu1570 Fully Covered Self-Expandable Metal Stents Outperform Straight Plastic Stents in Management of Benign Anastomotic Biliary Strictures following Orthotopic Liver Transplantation

Morales, Shannon J.; Chalhoub, Walid; Almario, Jose Alejandro; Sultan, Mohamed Thariq Hameed; Landsman, Marc; Loughney, Thomas M.; Haddad, Nadim

doi:10.1016/j.gie.2016.03.1276

Cited by 3 publications

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“…From 258 unique studies identified using the search strategy, we included 7, 4 RCTs [ 20 , 22 , 24 , 25 ] and 3 retrospective studies [ 21 , 23 , 26 ], whose characteristics are summarized in Table 1 . All the retrospective studies were published as congress abstracts [ 21 , 23 , 26 ], while RCTs were available as full-text papers. Overall, 379 patients were included, of whom 148 underwent ERCP with FCSEMS and 231 were treated with plastic stents.…”

Section: Resultsmentioning

confidence: 99%

“…Data from six studies with 272 patients were pooled for the analysis of stricture resolution. The study by Morales et al was excluded because it did not report the number of patients, but only the number of procedures [ 23 ]. As depicted in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies reported data on adverse events rate [ 20 , 21 , 23 - 25 ]. Complications were more frequent in the FCSEMS group, although not significantly so (OR 2.34, 95%CI 0.75-7.25; P=0.14) and with moderate heterogeneity (I 2 =44%, P=0.13; Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

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Management of anastomotic biliary stricture after liver transplantation: metal versus plastic stent

Facciorusso

Roşca

Ashimi

et al. 2018

aog

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BackgroundPost-transplant anastomotic biliary strictures remain refractory to endoscopic therapy in a considerable number of cases. The aim of this meta-analysis was to compare fully-covered self-expandable metal and plastic stents in the management of post-transplant biliary strictures.MethodsA meta-analysis was performed using a random effects model; results were expressed as odds ratio (OR) and mean standardized difference. The primary outcome was stricture resolution, while recurrence rate after stent placement, treatment time, and safety of the procedure were the secondary outcomes.ResultsThrough a systematic literature review until October 2017, we identified 7 studies, of which 4 were randomized controlled trials. Stricture resolution was slightly higher with metal stents, with no statistical difference between the two procedures (OR 1.38, 95% confidence interval [CI] 0.60-3.15; P=0.45) and low heterogeneity (I2=6%). Stricture recurrence showed a non-significant trend in favor of plastic stents (OR 1.82, 95%CI 0.52-6.31, P=0.35). Endoscopic retrograde cholangiopancreatography with placement of metal stents offered a significant improvement in terms of reduced treatment time (mean standardized difference: -3.58 months, 95%CI -6.23 to -0.93; P=0.008), but with more frequent complications, although not significantly so (OR 2.34, 95%CI 0.75-7.25; P=0.14). Sensitivity analysis confirmed all the findings.ConclusionMetal stents appear to be a promising tool that can decrease treatment time, although there is still no clear evidence of their superiority over plastic stents in terms of efficacy.

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