Removable fully covered self-expandable metal stents in the treatment of common bile duct strictures due to chronic pancreatitis: A case series

Cahen, Djuna L.; Rauws, Erik A.; Gouma, D. J.; Fockens, Paul; Bruno, M. J.

doi:10.1055/s-2008-1077353

Cited by 93 publications

(72 citation statements)

References 14 publications

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“…In addition, SEMS have recently been used for postoperative bile leaks, benign biliary strictures such as in chronic pancreatitis, or postoperative biliary strictures [14][15][16][17] . Nevertheless, stent occlusions do occur.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic removal and trimming of distal self-expandable metallic biliary stents

Ishii

Itoi²,

Sofuni

et al. 2011

WJG

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AIM:To evaluate the efficacy and safety of endoscopic removal and trimming of self-expandable metallic stents (SEMS). METHODS:All SEMS had been placed for distal biliary strictures. Twenty-seven endoscopic procedures were performed in 19 patients in whom SEMS (one uncovered and 18 covered) removal had been attempted, and 8 patients in whom stent trimming using argon plasma coagulation (APC) had been attempted at Tokyo Medical University Hospital. The APC settings were: voltage 60-80 W and gas flow at 1.5 L/min. RESULTS:The mean stent indwelling period for all patients in whom stent removal had been attempted was 113.7 ± 77.6 d (range, 8-280 d). Of the 19 patients in whom removal of the SEMS had been attempted, the procedure was successful in 14 (73.7%) without procedure-related adverse events. The indwelling period in the stent removable group was shorter than that in the unremovable group (94.9 ± 71.5 d vs 166.2 ± 76.2 d, P = 0.08). Stent trimming was successful for all patients with one minor adverse event consisting of self-limited hemorrhage. Trimming time ranged from 11 to 16 min. CONCLUSION:Although further investigations on larger numbers of cases are necessary to accumulate evidence, the present data suggested that stent removal and stent trimming is feasible and effective for stent-related complications.

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Section: Discussionmentioning

confidence: 99%

Endoscopic removal and trimming of distal self-expandable metallic biliary stents

Ishii

Itoi²,

Sofuni

et al. 2011

WJG

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“…In a small study (42) involving six patients, proximal migration of the stent occurred in two patients, one of which was still retrievable. After 4-6 months, the stents were safely retrieved in four patients with stricture resolution.…”

Section: Semsmentioning

confidence: 99%

Current status of endotherapy for chronic pancreatitis

Kwek

Maydeo²

2014

smedj

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Chronic pancreatitis is associated with varied morphological complications, including intraductal stones, main pancreatic ductal strictures, distal biliary strictures and pseudocysts. Endoscopic therapy provides a less invasive alternative to surgery. In addition, extracorporeal shockwave lithotripsy improves the success rate of endoscopic clearance of intraductal stones. However, recent data from randomised trials have shown better long-term outcomes with surgical drainage for obstructive pancreatic ductal disease. In patients with distal biliary strictures, stent insertion leads to good immediate drainage, but after stent removal, recurrent narrowing is common. Endoscopic drainage of pancreatic pseudocysts has excellent outcome and should be accompanied by pancreatic ductal stenting when a ductal communication is evident. In those who remain symptomatic, endoscopic ultrasonography-guided coeliac plexus block may provide effective but short-term pain relief. In this review, we present the current evidence for the role of endotherapy in the management of patients with chronic pancreatitis.

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“…Cahen et al [97] published a series of 6 patients with strictures resulting from CP receiving FCSEMS (Hanaro; M.I.Tech Co., Ltd., Seoul, South Korea), with 66% resolution, however 2 stents were unable to be removed requiring plastic stents placement through the other metal stent. More recently, Mahajan et al [90] analyzed a FCSEMS with anchoring fins (Viabil, Conmed, Utica, NY) to treat benign biliary strictures.…”

Section: Fully-covered Self-expandable Metal Stentsmentioning

confidence: 99%

Endoscopic management of chronic pancreatitis

Oza

Kahaleh²

2013

WJGE

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Chronic pancreatitis (CP) is a common gastrointestinal illness, which affects the quality of life with substantial morbidity and mortality. The management includes medical, endoscopic and surgical approaches with the need for interaction between various specialties, calling for a concerted multidisciplinary approach. However, at the time of this publication, guidelines to establish care of these patients are lacking. This review provides the reader with a comprehensive overview of the studies summarizing the various treatment options available, including medical, surgical and endoscopic options. In addition, technological advances such as endoscopic retrograde cholangiopancreatogrophy, endoscopic shock wave lithotripsy and endoscopic ultrasound can now be offered with reasonable success for pancreatic decompression, stricture dilatation with stent placement, stone fragmentation, pseudocyst drainage, and other endoscopic interventions such as celiac plexus block for pain relief. We emphasize the endoscopic options in this review, and attempt to extract the most up to date information from the current literature. The treatment of CP and its complications are discussed extensively. Complications such as biliary strictures. pancreatic pseudocysts, and chronic pain are common issues that arise as long-term complications of CP. These often require endoscopic or surgical management and possibly a combination of approaches, however choosing amongst the various therapeutic and palliative modalities while weighing the risks and benefits, makes the management of CP challenging. Treatment goals should be not just to control symptoms but also to prevent disease progression. Our aim in this paper is to advocate and emphasize an evidence based approach for the management of CP and associated long term complications.

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Removable fully covered self-expandable metal stents in the treatment of common bile duct strictures due to chronic pancreatitis: A case series

Cited by 93 publications

References 14 publications

Endoscopic removal and trimming of distal self-expandable metallic biliary stents

Endoscopic removal and trimming of distal self-expandable metallic biliary stents

Current status of endotherapy for chronic pancreatitis

Endoscopic management of chronic pancreatitis

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