Plastic or metal stents for benign extrahepatic biliary strictures: a systematic review

Boeckel, Petra G.A. van; Vleggaar, Frank P.; Siersema, Peter D.

doi:10.1186/1471-230x-9-96

Cited by 139 publications

(100 citation statements)

References 68 publications

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“…Strictures were subsequently treated by multiple placements of plastic stents (not FCSEMS). Although reports exist suggesting that temporary FCSEMS placement in benign strictures offers a potential alternative to the multiple plastic stent strategy [21,24,27], these findings have been challenged in literature [30]. We treated seven patients with benign biliary strictures using FCSEMS (unpublished data), and we observed complications in six patients.…”

Section: Discussionmentioning

confidence: 92%

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Canena

Liberato²,

Horta

et al. 2012

Surg Endosc

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Background Fully covered self-expandable metal stents (FCSEMS) have been used as a rescue therapy for several benign biliary tract conditions (BBC). Long-term stent placement commonly occurs, and prolonged FCSEMS placement is associated with the majority of the complications reported. This study evaluated the duration of stenting and the efficacy and safety of temporary FCSEMS placement for three BBCs: refractory biliary leaks, postsphincterotomy bleeding, and perforations. Methods This was a retrospective case series with longterm follow-up of 25 patients who underwent FCSEMS placement for BBCs. This study included 17 patients with postcholecystectomy refractory biliary leaks who had previously undergone unsuccessful sphincterotomy and plastic stent placement, 4 patients with difficult-to-control postsphincterotomy bleeding, and 4 patients with a perforation following endoscopic sphincterotomy. Stents were removed according to clinical evidence of problem resolution. The review included stenting duration, safe FCSEMS removal, clinical efficacy, complications, and long-term outcomes. During the follow-up period, ERCP and cholangioscopy procedures were performed to exclude the possibility of bile duct lesion development. Results Complete resolution of the initial condition was achieved in all patients. Patients with biliary leaks had a median stent duration time of 16 days (range 7-28 days). Patients with bleeding had stents removed after a median time of 6 days (range 3-15 days). Patients with perforations had their stents removed after a median time of 29.5 days (range 21-30 days). There were no complications related to stenting. Conclusions Temporary placement of a FCSEMS for 30 days or less is an effective rescue therapy for refractory biliary leaks, difficult-to-control post-endoscopic sphincterotomy bleeding, and perforations. Duration of stenting should be different for each type of condition. Stents can be safely removed, and short-term stenting is associated with the absence of early and late complications.

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Section: Discussionmentioning

confidence: 92%

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Canena

Liberato²,

Horta

et al. 2012

Surg Endosc

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“…Recently, FCSEMS have become commercially available and in some countries they have only received approval for malignant biliary strictures and not to treat BBS. Furthermore, as they have only been introduced in recent years there are few studies on their use compared with several other models of FCSEMS, and an even fewer number of studies comparing their efficacy with plastic stents, which still remain the standard for treatment of BBS [21] . Some studies on PCSEMS or FCSEMS in BBS are shown in Table 3 [22 -28] .…”

Section: Benign Biliary Stricturesmentioning

confidence: 99%

Use of fully covered self-expanding metal stents in benign biliary diseases

García-Cano

2012

WJGE

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Biliary fully covered self-expanding metal stents (FC-SEMS) are now being used to treat several benign biliary conditions. Advantages include small predeployment and large postexpansion diameters in addition to an easy insertion technique. Lack of imbedding of the metal into the bile duct wall enables removability. In benign biliary strictures that usually require multiple procedures, despite the substantially higher cost of FCSEMS compared with plastic stents, the use of FC-SEMS is offset by the reduced number of endoscopic retrograde cholangiopancreatography interventions required to achieve stricture resolution. In the same way, FCSEMS have also been employed to treat complex bile leaks, perforation and bleeding after endoscopic biliary sphincterotomy and as an aid to maintain permanent drainage tracts obtained by means of Endoscopic Ultrasound-guided biliary drainage. Good success rates have been achieved in all these conditions with an acceptable number of complications. FCSEMS were successfully removed in all patients. Comparative studies of FCSEMS and plastic stents are needed to demonstrate efficacy and cost-effectiveness

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“…9,79 Two systematic reviews showed a 94% success rate with placement of multiple plastic stents, 80% with cSEMS, and 60% with single plastic stents. 9,79 Endoscopic success in stricture resolution for postoperative strictures is around 80% and 20% in chronic pancreatitis strictures. 80 Catalano et al showed that multiple simultaneous plastic stents are superior to single stent placement.…”

Section: Plastic Vs Metal Stentsmentioning

confidence: 99%

An Update to Hepatobiliary Stents

Moy¹,

Bir²

2015

JCTH

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Endoscopic stent placement is a common primary management therapy for benign and malignant biliary strictures. However, continuous use of stents is limited by occlusion and migration. Stent technology has evolved significantly over the past two decades to reduce these problems. The purpose of this article is to review current guidelines in managing malignant and benign biliary obstructions, current endoscopic techniques for stent placement, and emerging stent technology. What began as a simple plastic stent technology has evolved significantly to include uncovered, partially covered, and fully covered self-expanding metal stents (SEMS) as well as magnetic, bioabsorbable, drug-eluting, and antireflux stents.

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Plastic or metal stents for benign extrahepatic biliary strictures: a systematic review

Cited by 139 publications

References 68 publications

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Short-term stenting using fully covered self-expandable metal stents for treatment of refractory biliary leaks, postsphincterotomy bleeding, and perforations

Use of fully covered self-expanding metal stents in benign biliary diseases

An Update to Hepatobiliary Stents

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