Intentional Retrieval of Viabil Stent-Grafts from the Biliary System

Kuo, Michael; LoPresti, David C.; Gover, David D.; Hall, Lee D.; Ferrara, Steven L.

doi:10.1097/01.rvi.0000194867.86371.0b

Cited by 37 publications

(28 citation statements)

References 15 publications

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“…However, significant strictures recurred in 4 (50%) of the 8 lesions 5-6 months after stent removal. Kue et al 10 also reported a 100% successful removal rate of fully covered metal stents (Viabil; W.L. Gore & Associates, Flagstaff, AZ) in 5 patients (including 3 liver transplant recipients) at a mean of 38 days after percutaneous transhepatic stent placement and without complications, although the clinical outcomes were not available.…”

Section: Discussionmentioning

confidence: 99%

“…placement of covered retrievable stents is feasible for treating biliary strictures following liver transplantation. 9,10 However, these studies dealt with small groups of orthotopic liver transplant recipients (fewer than 8) during short follow-up periods. We assumed that the treatment of post-LDLT biliary strictures using retrievable covered stents might have advantages over indwelling catheters placed after balloon dilation because of the larger diameters of the stents.…”

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confidence: 99%

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

Kim

Sung

et al. 2010

Liver Transpl

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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

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Kim

Sung

et al. 2010

Liver Transpl

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“…term patency in malignant stenoses and carry a low risk of tissue ingrowth and sludge accumulation [1,4,5]. This sup− ports the feasibility of intentional retriev− al and allows the endoscopist greater lati− tude when extended time periods of stent placement are necessary [1]. …”

Section: Videomentioning

confidence: 99%

“…Because of its exoskeleton struc− ture (l " Fig. 4), the Viabil stent is able to collapse during withdrawal and seems a feasible option when balloon dilatation of a benign stricture is not sufficient [1]. Coated stents have proven good long− Biliary stenting and successful intentional stent retrieval after 6 months in a benign stricture following hepaticojejunostomy Fig.…”

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Biliary stenting and successful intentional stent retrieval after 6 months in a benign stricture following hepaticojejunostomy

Renteln¹,

Riecken²,

Ulmer³

et al. 2007

Endoscopy

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Percutaneous transhepatic treatment of hepaticojejunal anastomotic biliary strictures after living donor liver transplantation

Sung

Yoon

et al. 2008

Liver Transpl

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Endoscopic treatment has largely replaced surgery as the initial treatment for biliary strictures following living donor liver transplantation; however, this treatment is nearly impossible in patients who have previously undergone hepaticojejunostomy (HJ). We therefore retrospectively evaluated the efficacy of percutaneous transhepatic treatment in patients who developed HJ strictures following living donor liver transplantation. Percutaneous transhepatic biliary drainage and subsequent balloon dilation of biliary strictures were performed on 83 patients. Serial exchanges of drainage tubes with larger diameters up to 14 Fr were performed at 4-week intervals. Drainage tubes were removed if follow-up cholangiography revealed fluent passage of the contrast medium without recurrence of symptoms or changes in the biochemical findings. The clinical outcome, tube independence rate, and patency rate following drainage tube removal were retrospectively evaluated. Except for 2 patients who had failed negotiation of biliary strictures, clinical success was achieved in all 81 patients following percutaneous transhepatic treatment, and the drainage tubes were removed from 76 (93.8%) of these 81 patients. Tubes were removed 11.2 Ϯ 7.4 months after initial percutaneous transhepatic biliary drainage. The recurrence rate at a mean of 36.0 Ϯ 26.2 months following drainage tube removal was 15.8%. One-and three-year primary patency rates were 95.3% Ϯ 2.7% and 80.9% Ϯ 5.2%, respectively. In conclusion, percutaneous transhepatic treatment is an effective alternative treatment for HJ strictures following living donor liver transplantation. However, further research will be required in order to minimize the duration of treatment and the stricture recurrence rate following tube removal.

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Intentional Retrieval of Viabil Stent-Grafts from the Biliary System

Cited by 37 publications

References 15 publications

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

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

Biliary stenting and successful intentional stent retrieval after 6 months in a benign stricture following hepaticojejunostomy

Percutaneous transhepatic treatment of hepaticojejunal anastomotic biliary strictures after living donor liver transplantation

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