REVIEW   

Minerva Gastroenterologica e Dietologica 2019 March;65(1):63-9

DOI: 10.23736/S1121-421X.18.02506-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Single brand, fully-covered, self-expandable metal stent for the treatment of benign biliary disease: when should stents be removed?

Benedetto MANGIAVILLANO ^{1, 2} ✉, Mouen A. KHASHAB ³, Leonardo H. EUSEBI ⁴, Ilaria TARANTINO ⁵, Mario BIANCHETTI ¹, Rossella SEMERARO ⁶, Rinaldo PELLICANO ⁷, Mario TRAINA ⁵, Alessandro REPICI ^{2, 6}

¹ Unit of Gastrointestinal Endoscopy, Humanitas - Mater Domini, Castellanza, Varese, Italy; ² Humanitas University - Hunimed, Milan Italy; ³ Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA; ⁴ Unit of Gastroenterology, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; ⁵ Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT), Palermo, Italy; ⁶ Digestive Endoscopy Unit, Istituto Clinico Humanitas Research Hospital, Rozzano, Milan, Italy; ⁷ Unit of Gastroenterology, Molinette Hospital, Turin, Italy

The two most relevant endoscopic treatable benign biliary diseases (BBD) are benign biliary strictures (BBSs) and biliary leaks (BLs), often associated with high morbidity. The most common endoscopic treatment for biliary strictures involves placement of multiple plastic stents (PSs), with or without balloon dilation, followed by planned exchange of the stents. Thus, there continues to be high interest in pursuing alternative endoscopic approaches that may achieve better results with fewer interventions. In this setting, the use of a fully-covered, self-expandable metal stent (FCSEMS) is an attractive alternative to single or multiple PSs for the treatment of BBDs. A single metal stent can remain in place for a longer period of time before removal; however, the maximum time the stent can be remain in place is still not well defined. The aim of this review is to determine the removal time of the TaeWoong® FCSEMS, placed for BBD. According to our data analysis, considering the absence of loss of the covering of the FCSEMS and of any adverse events during and after stent removal, leaving the TaeWoong medical FCSEMS in situ for an 8 months’ period seems to be acceptable for benign biliary diseases. Further studies need to evaluate their removability at 1 year.

KEY WORDS: Stents - Cholangiopancreatography, endoscopic retrograde - Gallbladder diseases