Use of Fully Covered Self-Expandable Stent in Biliary Complications After Liver Transplantation: A Case Series

Marín-Gómez, L.M.; Sobrino-Rodríguez, Salvador; Álamo-Martínez, J.M.; Suárez-Artacho, G.; Bellido, C. Bernal; Serrano-Díaz-Canedo, J.; Padillo-Ruíz, Javier; Gómez‐Bravo, Miguel Ángel

doi:10.1016/j.transproceed.2010.08.023

Cited by 16 publications

(19 citation statements)

References 7 publications

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“…There was a 24% migration rate but only a 9.6% failure rate and 7.1% stricture recurrences. The results were no different between initial and secondary treatments [31].…”

Section: Chronic Pancreatitis (Cp)mentioning

confidence: 71%

“…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]. The concerns for problems with the proximal uncovered portion of the stent resulted in the development and use of fully covered SEMS (fcSEMS) [20,[30][31][32]. The first two studies used either the Nit-S ComVi ® (Taewoong Medical Seoul, Korea) in 16 patients [30] or the Wallflex ® (Boston Scientific, Natik, MA) in 11 patients, all of whom had failed prior therapy with dilation or plastic stent placement.…”

Section: Chronic Pancreatitis (Cp)mentioning

confidence: 99%

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Benign Biliary Strictures

Cunningham

2014

Ercp

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“…There was a 24% migration rate but only a 9.6% failure rate and 7.1% stricture recurrences. The results were no different between initial and secondary treatments [31].…”

Section: Chronic Pancreatitis (Cp)mentioning

confidence: 71%

Section: Chronic Pancreatitis (Cp)mentioning

confidence: 99%

Benign Biliary Strictures

Cunningham

2014

Ercp

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“…However, more recently has been used as a first-line measure in patients with complex and high-grade leaks [19, 20]. …”

Section: Discussionmentioning

confidence: 99%

Biliary Leak in Post-Liver-Transplant Patients: Is There Any Place for Metal Stent?

et al. 2012

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Objectives. Endoscopic management of bile leak after orthotopic liver transplant (OLT) is widely accepted. Preliminary studies demonstrated encouraging results for covered self-expandable metal stents (CSEMS) in complex bile leaks. Methods. Thirty-one patients with post-OLT bile leaks underwent endoscopic temporary placement of CSEMS (3 partially CSEMS , 18 fully CSEMS with fins and 10 fully CSEMS with flare ends) between December 2003 and December 2010. Long-term clinical success and safety were evaluated. Results. Median stent indwelling and follow-up were 89 and 1,353 days for PCSEMS, 102 and 849 for FCSEMS with fins and 98 and 203 for FCSEMS with flare ends. Clinical success was achieved in 100%, 77.8%, and 70%, respectively. Postplacement complications: cholangitis (1) and proximal migration (1), both in the FCSEMS with fins. Postremoval complications were biliary strictures requiring drainage: PCSEMS (1), FCSEMS with fins (6) and with flare ends (1). There was no significant differences in the FCSEMS groups regarding clinical success, age, gender, leak location, previous treatment, stent indwelling, and complications. Conclusion. Temporary placement of CSEMS is effective to treat post-OLT biliary leaks. However, a high number of post removal biliary strictures occurred especially in the FCSEMS with fins. CSEMS cannot be recommended in this patient population.

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“…In a small series, including 11 patients with complications after liver transplantation, eight of whom with biliary stenosis and three with biliary leakage, placement of CSEMS was successful in avoiding hepaticojejunostomies in six from nine patients [11]. …”

Section: Csems For Treatment Of Anastomosis Stenosis Following LIVmentioning

confidence: 99%

“…In this setting, however, stent migration seems to be a relevant problem occurring in between 30 and 50% of the cases, although presenting with no clinical consequences in most patients [11, 13]. …”

Section: Csems For Treatment Of Anastomosis Stenosis Following LIVmentioning

confidence: 99%

Fully Covered Self-Expandable Metal Stents for Treatment of Both Benign and Malignant Biliary Disorders

Samie

Theilmann

2012

Diagnostic and Therapeutic Endoscopy

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Transpapillary stents are increasingly being used for biliary strictures, whether benign or malignant. However, there are different stent types and available data is controversial. Recently, completely covered self-expandable metal stents (CSEMSs) have been proposed as an alternative therapeutic option in different biliary indications, including strictures of the distal bile duct, anastomotic stenosis after orthotopic liver transplantation, bile duct leaks, periampullary perforation following endoscopic sphincterotomy (ES), and postsphincterotomy bleeding. Despite the higher costs of these devices, fully covered self-expanding metal stents seem to be a suitable therapeutic option to relief biliary obstruction due to bile duct stenosis, regardless of the underlying cause.

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Use of Fully Covered Self-Expandable Stent in Biliary Complications After Liver Transplantation: A Case Series

Cited by 16 publications

References 7 publications

Benign Biliary Strictures

Benign Biliary Strictures

Biliary Leak in Post-Liver-Transplant Patients: Is There Any Place for Metal Stent?

Fully Covered Self-Expandable Metal Stents for Treatment of Both Benign and Malignant Biliary Disorders

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