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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

A Journal on Gastroenterology, Nutrition and Dietetics


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Minerva Gastroenterologica e Dietologica 2017 Sep 05

DOI: 10.23736/S1121-421X.17.02428-X

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Use of fully covered self expanding metal stents for benign biliary etiologies: a large multi-center experience

Abdul HASEEB 1, Ali SIDDIQUI 2, Linda J. TAYLOR 1, Alyssa MILLS 1, Thomas E. KOWALSKI 2, David E. LOREN 2, Jessica DAHMUS 2, Silpa YALAMANCHILI 2, Christopher CAO 2, Andrew CANAKIS 2, Tayebah MUMTAZ 2, Meet PARIKH 2, Douglas G. ADLER 1

1 Division of Gastroenterology, School of Medicine, University of Utah, Salt Lake City, UT, USA; 2 Division of Gastroenterology, School of Medicine, Thomas Jefferson University, Philadelphia, PA, USA


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INTRODUCTION: Fully-covered self-expandable metal stents (FCSEMS) have been used in benign biliary diseases although reported data is limited. These devices are most commonly used to treat biliary leaks, strictures, or both. The aim of this study was to evaluate effectiveness of FCSEMS in treating benign biliary disease and recognize the associated complications.
METHODS: We performed a multi-center longitudinal retrospective cohort study of patients with benign biliary disease needing FCSEMS between 2011 and 2016. Descriptive statistics were performed using SPSS version 24 (SPSS Inc, Chicago, Ill) and continuous variables were presented as mean ± standard deviation.
RESULTS: 75 patients, 73% M/27% F, with a mean age of 51.1± 16.7 years, were included. 63 (84%) had benign strictures, 7 patients had leaks, and 4 patients had both a leak and a stricture. Chronic pancreatitis was the most common cause of BBS (35%) and cholecystectomy was the most common cause of leaks. FCSEMS placement was technically successful in all patients. Four patients died of unrelated causes. A recurrent stricture was observed in 24 (32%) of the patients. Recurrent strictures were most commonly seen in patients with chronic pancreatitis 12/35 (34%). Stent migration occurred in 8/75 patients (10.7%). 7 patients (9.3%) had adverse events, acute pancreatitis (n=4) was most common.
CONCLUSIONS: FCSEMS are safe and effective for treating biliary strictures and leaks. We report decreased rates of stent migration compared to previous studies. Prospective studies are needed to compare plastic stents with FCSEMS, determine optimal stent in-dwell times and cost effectiveness of FCSEMS.

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Publication History

Article first published online: September 05, 2017
Manuscript accepted: August 30, 2017
Manuscript received: July 29, 2017

Cite this article as

Haseeb A, Siddiqui A, Taylor L, Mills A, Kowalski T, Loren DE, et al. Use of fully covered self expanding metal stents for benign biliary etiologies: a large multi-center experience. Minerva Gastroenterol Dietol 2017 Sep 05. DOI: 10.23736/S1121-421X.17.02428-X

Corresponding author e-mail

Douglas.adler@hsc.utah.edu