Mo1498 A Long Term Results (Up to 5 Years) of a Prospective Randomized Analysis of Plastic Versus Covered Self-Expandable Metal Stent in Patients With Post-Surgical Stricture

Artifon, Everson Luiz de Almeida; Aparicio, Dayse P.; Ferreira, Francirosy Campos Barbosa; Paione, Jose B.

doi:10.1016/j.gie.2011.03.796

Cited by 3 publications

(8 citation statements)

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“…No additional relevant article was identified from the review of bibliographies. After the full texts of these 17 articles were reviewed, 8 studies [7–9,12–16] with 524 patients were included in the final analysis. There were 261 patients in the MPS group and 263 in the CSEMS group.…”

Section: Resultsmentioning

confidence: 99%

“…All studies except two [14,16] that we included in our meta-analysis used FCSEMS. One study [16] used partially covered self-expandable metal stents (PCSEMS) in all patients, and one study [14] used PCSEMS in one-third of patients and FCSEMS in two-thirds. We performed subgroup analysis including the studies that used FCSEMS only and results remained consistent.…”

Section: Discussionmentioning

confidence: 99%

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Metal versus plastic stents in the management of benign biliary strictures: systematic review and meta-analysis of randomized controlled trials

Kamal

Khan

Lee‐Smith³

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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Benign biliary strictures (BBS) are usually treated with endoscopic retrograde cholangiopancreatography (ERCP) with the placement of multiple plastic stents (MPS) or a covered self-expandable metal stent (CSEMS). In this meta-analysis, we compared the efficacy and safety of MPS and CSEMS in the management of BBS. We reviewed several databases from inception to 28 April 2021 to identify RCTs that compared MPS with CSEMS in the management of BBS. Our outcomes of interest were stricture resolution, stricture recurrence, adverse events, stent migration and mean number of ERCPs to achieve stricture resolution. Data were analyzed using a random-effects model. We included eight RCTs with 524 patients. We found no significant difference in the rate of stricture resolution (risk ratio, 1.02; 95% CI, 0.96–1.10), stricture recurrence (risk ratio, 1.68; 95% CI, 0.72–3.88) or adverse events (risk ratio, 1.17; 95% CI, 0.73–1.87) between groups. Mean number of ERCPs was significantly lower in the CSEMS group (SMD, −1.99; 95% CI, −3.35 to −0.64). The rate of stent migration was significantly higher in the CSEMS group. CSEMS are comparable in efficacy and safety to MPS in the management of BBS but require fewer ERCPs to achieve stricture resolution.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Metal versus plastic stents in the management of benign biliary strictures: systematic review and meta-analysis of randomized controlled trials

Kamal

Khan

Lee‐Smith³

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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“…Distal BBSs consist of biliary stricture due to chronic pancreatitis, post deceased-donor liver transplantation biliary anastomotic stricture, and postcholecystectomy biliary stricture. Several RCTs and metaanalyses show that the temporary placement of a fully-covered SEMS achieves similar stricture resolution to multiple PSs with fewer sessions of ERCP [150][151][152][153][154][155][156][157]. BBS due to chronic pancreatitis is sometimes refractory to biliary stenting because of severe fibrosis resulting from chronic inflammation.…”

Section: Endoscopic Approach For Benign Biliary Stricturesmentioning

confidence: 99%

Current endoscopic approaches to biliary strictures

Shimoda

Nakai

Fujishiro

2022

Current Opinion in Gastroenterology

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Purpose of reviewTo summarize the current status and future perspectives of the endoscopic management of biliary strictures.Recent findingsIn addition to conventional diagnostic modalities, such as cross-sectional imaging and endoscopic ultrasonography (EUS), per-oral cholangioscopy is helpful for indeterminate biliary strictures. It allows direct visualization of the biliary tract and targeted biopsy. For distal malignant biliary obstruction (MBO), a self-expandable metal stent (SEMS) via endoscopic retrograde cholangiopancreatography (ERCP) is a standard of care. EUS-guided biliary drainage (EUS-BD) is an emerging alternative to percutaneous transhepatic biliary drainage in cases with failed ERCP. EUS-BD is also an effective salvage option for perihilar MBO, which can not be managed via ERCP or percutaneous transhepatic biliary drainage. Preoperative drainage is necessary for most jaundiced patients as neoadjuvant chemotherapy is widely administered for resectable and borderline resectable pancreatic cancer, and a SEMS is preferred in this setting, too. For benign biliary strictures, a covered SEMS can improve stricture resolution and reduce the number of endoscopic sessions as compared to plastic stents.SummaryERCP and EUS play a central role in the diagnosis and drainage for both malignant and benign biliary strictures.

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“…83 Only 1 RCT compared MPS with partially covered SEMS and reported increased long-term patency with SEMS, despite the tendency for more AEs. 111 Costamagna and colleagues evaluated the long-term outcomes of patients treated with MPS (n = 154). MPS treatment success rate was 96.7% and the recurrence rate was 9.4% (mean follow-up of 11.2 y).…”

Section: Benign Stricturesmentioning

confidence: 99%

“…Post-cholecystectomy benign biliary strictures (PCBS) are usually short and often located in the upper third of the common bile duct (CBD), sometimes near or involving the hepatic confluence, which may hamper the use of FC-SEMS because of the risk of side-branch occlusion 83 . Only 1 RCT compared MPS with partially covered SEMS and reported increased long-term patency with SEMS, despite the tendency for more AEs 111 . Costamagna and colleagues evaluated the long-term outcomes of patients treated with MPS (n=154).…”

Section: Biliary Stentingmentioning

confidence: 99%

Best Practices in Pancreatico-biliary Stenting and EUS-guided Drainage

Medas

Ferreira‐Silva

Girotra

et al. 2022

Journal of Clinical Gastroenterology

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Indications for endoscopic placement of endoluminal and transluminal stents have greatly expanded over time. Endoscopic stent placement is now a well-established approach for the treatment of benign and malignant biliary and pancreatic diseases (ie, obstructive jaundice, intra-abdominal fluid collections, chronic pancreatitis etc.). Ongoing refinement of technical approaches and development of novel stents is increasing the applicability and success of pancreatico-biliary stenting. In this review, we discuss the important developments in the field of pancreatico-biliary stenting, with a specific focus on endoscopic retrograde cholangiopancreatography and endoscopic ultrasound-associated developments.

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Mo1498 A Long Term Results (Up to 5 Years) of a Prospective Randomized Analysis of Plastic Versus Covered Self-Expandable Metal Stent in Patients With Post-Surgical Stricture

Cited by 3 publications

References 0 publications

Metal versus plastic stents in the management of benign biliary strictures: systematic review and meta-analysis of randomized controlled trials

Metal versus plastic stents in the management of benign biliary strictures: systematic review and meta-analysis of randomized controlled trials

Current endoscopic approaches to biliary strictures

Best Practices in Pancreatico-biliary Stenting and EUS-guided Drainage

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