Temporary placement of partially covered self-expandable metal stents for anastomotic biliary strictures after liver transplantation: a prospective, multicenter study

Chaput, Ulriikka; Scatton, Olivier; Bichard, Philippe; Ponchon, Thierry; Chryssostalis, Ariane; Gaudric, M; Mangialavori, Luigi; Duchmann, Jean-Christophe; Massault, Pierre-Philippe; Conti, Filoména; Calmus, Yvon; Chaussade, Stanislas; Soubrane, Olivier; Prat, Frédéric

doi:10.1016/j.gie.2010.08.016

Cited by 98 publications

(73 citation statements)

References 29 publications

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“…Stent patency ranges from 2 to 4 mo, due to presence of casts, debris and clots; it is indicated to exchange plastic stents every 3 mo for the first 9-12 mo, placing larger ones or multiple stents, until the resolution of the stenosis. We suggest evaluating the presence of residual stricture assessing the resistance to the transit of inflated balloon catheter through the anastomosis [14][15][16][17][18] . A recent systematic review reported a 80%-95% of stricture resolution after endoscopic placement of fully covered self-expanding metal stents (SEMS); however a study reporting the use of SEMS in patients with post-LT AS reported a significant rate of complications (up to 38%, mostly cholangitis) with worse clinical outcome (68% of stricture resolution) [19,20] .…”

Section: Biliary Stricturementioning

confidence: 99%

Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation

Lisotti¹

2015

WJH

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The clinical outcome of patients receiving liver trans plantation could be significantly affected by biliary complications, including strictures, leaks, stones and bilomas; early diagnosis and treatment of these con ditions lead to markedly reduction in morbidity and mortality. Therapeutic gold standard is represented by conservative approaches, both endoscopic and percutaneous, based on the type of biliary reconstruction, the local availability of the procedures and specific expertise. In patients with previous transplantation, the difficult biliary access and the possible presence of concomitant complications (mainly strictures) further restrict the efficacy of the endoscopic and percutaneous treatments; on the other hand, surgery should generally be avoided because of the even increased morbidity and mortality due to technical and clinical issues. Here we review the most common biliary complications occurring after liver transplantation and discuss available treatment options including future perspectives such as endoscopic ultrasoundguided biliary access in patients with Roux enY choledochojejunostomy or extracorporeal shock wave lithotripsy for difficult stones. Author contributions: Lisotti A and Fusaroli P wrote the paper; Caletti G revised the final draft of the manuscript for important intellectual content.Conflictofinterest statement: All Authors declare no conflict of interest for this study and for the preparation of this manuscript.OpenAccess: This article is an openaccess article which was selected by an inhouse editor and fully peerreviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BYNC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See: http://creativecommons.org/ licenses/bync/4.0/ Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation scopic knowledge and expertise, the interventional management of these conditions is constantly evolving toward a conservative approach. In this manuscript are summarized current evidences regarding conservative approaches to biliary complication, with an overview on future management and research areas.Lisotti A, Fusaroli P, Caletti G. Role of endoscopy in the con servative management of biliary complications after deceased donor liver transplantation.

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Section: Biliary Stricturementioning

confidence: 99%

Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation

Lisotti¹

2015

WJH

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“…33 FC-SEMS have been proposed to dilate anastomotic strictures following OLT because their removability was safe and possible in almost all cases; results are still under evaluation due to the high incidence of stents migration and the high stricture recurrence rate at the 2-year follow-up (Table 3). 26,28,47,48 Biliary strictures secondary to chronic pancreatitis Chronic pancreatitis (CP) is an inflammatory process characterized by destruction of pancreatic parenchyma and ductal structures with subsequent formation of fibrosis. 49 Strictures of the common bile duct (CBD) can be found in 3-46% of patients with advanced CP.…”

Section: Postcholecystectomy Biliary Stricturesmentioning

confidence: 99%

Endoscopic approach to benign biliary obstruction

Tringali

Bove

Costamagna

2015

Gastrointestinal Intervention

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a b s t r a c tDuring the past 30 years, the endoscopic approach to benign biliary strictures (BBS) became the preferred "mini-invasive" treatment modality for benign diseases. Endoscopic plastic or metallic stenting, and balloon dilation represent the gold standard treatment for BBS. Side-by-side insertion of multiple plastic stents is a very effective treatment option for BBS following cholecystectomy or liver transplantation. This strategy has a low recurrence rate on long-term follow-up, with better results than fully covered self-expandable metal stents (FC-SEMS). FC-SEMS seems to have an advantage and higher stricture resolution rate in patients with BBS secondary to chronic pancreatitis. Dilation of dominant biliary strictures in patients with primary sclerosing cholangitis has a lower rate of infective complications than the stenting treatment. Endoscopic retrograde cholangiopancreatography represents a safe and effective approach to BBS, with a very high success rate, especially when such cases are managed in a multidisciplinary setting.

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“…In one study, stent migration resulted in initial failure in 13.6%, and with stricture recurrence of 47% [28]. A second study with the same device reported a high initial success rate for short-term stenting for postoperative strictures (100%) and OLTX strictures (94%); however, some of the extractions were difficult due to proximal migration, and one patient had a duct rupture during stent extraction with a dilation balloon, which resolved with plastic stents [29].…”

Section: Chronic Pancreatitis (Cp)mentioning

confidence: 99%

Benign Biliary Strictures

Cunningham

2014

Ercp

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Temporary placement of partially covered self-expandable metal stents for anastomotic biliary strictures after liver transplantation: a prospective, multicenter study

Cited by 98 publications

References 29 publications

Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation

Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation

Endoscopic approach to benign biliary obstruction

Benign Biliary Strictures

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