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

García-Cano, Jesús

doi:10.4253/wjge.v4.i4.142

Cited by 14 publications

(7 citation statements)

References 43 publications

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“…[23] Many publications suggest that late-detected BL and patients with diffuse peritonitis should wait three months for definitive surgery after primary control surgery to relieve the inflammation for best results. [1,23,24] Roux-Y HJ is usually preferred as surgical procedure. [25,26] However, depending on the type of injury, more complicated procedures like Kasai can also be performed.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic and Surgical Management of Iatrogenic Biliary Tract Injuries

Acar

Güngör

et al. 2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Iatrogenic biliary tract injury (BTI) is a rare complication but has high risks of morbidity and mortality when it is not early noticed. Although the treatment varies depending on the size of injury and the time until the injury is noticed, endoscopic and percutaneous interventions are usually sufficient. However, it should be remembered that these interventions may cause major complications in the following years, such as biliary stricture, recurrent episodes of cholangitis and even cirrhosis. In this paper, we aimed to present our approach to BTI following cholecystectomy and our treatment management in the light of the literature. METHODS:The medical records of 105 patients who were treated for BTI between January 2015 and July 2019 were evaluated retrospectively. The majority of the patients consisted of the patients who underwent cholecystectomy at an external medical center and were referred to our clinic due to biliary leakage (BL). Patients were grouped according to Strasberg classification determined by the place of leakage. RESULTS:Among 105 patients included in this study, 55 were male, and 50 were female. Mean age was 55.2 ±16.26 years (range, 21-93 years). According to Strasberg classification, type A, B, C, D and E injuries were detected in 57, 1, 3, 29 and 15 patients, respectively. Eighty-five patients were successfully treated with endoscopic and percutaneous interventions, while 20 patients underwent surgery. CONCLUSION:In all patients with suspected BTI, a detailed screening and appropriate treatment provide a significant decline in morbidity and mortality. Therefore, early diagnosis is very important for both early and late outcomes.

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Section: Discussionmentioning

confidence: 99%

Endoscopic and Surgical Management of Iatrogenic Biliary Tract Injuries

Acar

Güngör

et al. 2020

Ulus Travma Acil Cerrahi Derg

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“…Biliary stenting with an FCSEMS enables stent removal according to clinical needs 15 . Uncovered SEMS usually cannot be removed after placement, but occlusion of an uncovered SEMS usually can be managed endoscopically by placing a second biliary stent in a stent-in-stent fashion 16 .…”

Section: Discussionmentioning

confidence: 99%

Safety, efficacy, and removability of a fully covered multi-hole metal stent in a swine model of hilar biliary stricture: a feasibility study

et al. 2019

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Background and study aims Use of fully covered self-expandable metal stents (FCSEMS) for biliary drainage of malignant hilar biliary strictures is limited because of risk of cholangitis due to side branch obstruction. The aim of this study was to evaluate the safety and efficacy of unilateral placement of a multi-hole FCSEMS (FCSEMS-MH), which had a 2.5-mm hole in the center of the membrane on each cavity, in a swine model of hilar biliary stricture. Materials and methods Six female mini pigs were included in this prospective study. The hilar biliary stricture model was prepared using an endobiliary radiofrequency ablation. FCSEMS-MHs were endoscopically inserted into the peri-hilar bile duct of all the animals. Outcomes were assessed in terms of adverse events (AEs) including cholangitis, stent patency, stent migration, and endoscopic stent removability for 1 month after stenting. Results In terms of hilar biliary stricture types, two animals were of Bismuth type I and four were of type II. Technical success rate for endoscopic metal stenting was 100 % (6/6), and the functional success rate, which was evaluated 7 days after stent insertion, was also 100 % (5/5). The immediate overall AE rate was 0 %. There was no procedure-related mortality and stent migration did not occur in any animal during the 4-week stent indwelling period. Stents were removed from all six animals at 4 weeks post-stenting. Conclusion Unilateral placement of FCSEMS-MH might be safe and effect for swine hilar biliary stricture models. However, long-term follow-up and comparative studies are needed to verify the usefulness of this stent.

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“…In contrast, FCSEMS can expand to a large stent diameter equivalent to three 10 Fr stents, and its chemical covering limits tissue hyperplasia and in-growth. A single FCSEMS can remain in place for a prolonged period without the need for repeated stent exchange prior to removal[ 44 , 45 ].…”

Section: Benign Biliary Stricturesmentioning

confidence: 99%

Fully covered metal biliary stents: A review of the literature

Lam¹,

Muniraj²

2021

WJG

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Fully covered self-expandable metal stents (FCSEMS) represent the latest advancement of metal biliary stents used to endoscopically treat a variety of obstructive biliary pathology. A large stent diameter and synthetic covering over the tubular mesh prolong stent patency and reduce risk for tissue hyperplasia and tumor ingrowth. Additionally, FCSEMS can be easily removed. All these features address issues faced by plastic and uncovered metal stents. The purpose of this paper is to comprehensively review the application of FCSEMS in benign and malignant biliary strictures, biliary leak, and post-sphincterotomy bleeding.

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

Cited by 14 publications

References 43 publications

Endoscopic and Surgical Management of Iatrogenic Biliary Tract Injuries

Endoscopic and Surgical Management of Iatrogenic Biliary Tract Injuries

Safety, efficacy, and removability of a fully covered multi-hole metal stent in a swine model of hilar biliary stricture: a feasibility study

Fully covered metal biliary stents: A review of the literature

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