Giovanni Mauri1,2, Caterina Michelozzi3, Fabio Melchiorre4, Dario Poretti5, Vittorio Pedicini5, Monica Salvetti6, Eva Criado7, Joan Falcò Fages7, Miguel Ángel De Gregorio8, Alicia Laborda8, Luca Maria Sonfienza9,10, Gianpaolo Cornalba4,11, Lorenzo Monfardini12, Jiri Panek13, Tomas Andrasina13, Mariano Gimenez14. 1. Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, 20097, San Donato Milanese, Milano, Italy. vanni.mauri@gmail.com. 2. Dipartimento di di Immagini e Scienze Radiologiche, Divisione di Radiologia Interventistica, Istituto Europeo di Oncologia, Milano, Italy. vanni.mauri@gmail.com. 3. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milano, Italy. 4. Dipartimento di Diagnostica per Immagini, Ospedale San Paolo, Milano, Italy. 5. Servizio di Radiologia Oncologica e Interventistica, IRCCS Istituto Clinico Humanitas, Rozzano, Milano, Italy. 6. S.S. Gastroenterologia Diagnostica e Interventistica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. 7. Unit of Interventional Radiology, UDIAT Hospital Universitario Parc Tauli, Sabadell, Spain. 8. Unidad de Cirugia Minimamente Invasiva Guiada por Imagen, Universidad de Zaragoza, Zaragoza, Spain. 9. Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, 20097, San Donato Milanese, Milano, Italy. 10. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy. 11. Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy. 12. Dipartimento di Radiologia-Radilogia Interventistica, Fondazione Poliambulanza-Brescia, Brescia, Italy. 13. Department of Radiology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic. 14. Gastrointestinal and HPB Surgery Hospital de Clinicas University of Buenos Aires, DAICIM Foundation, Arenales 1640, 1 piso, Buenos Aires, Argentina. marianoegimenez@gmail.com.
Abstract
OBJECTIVES: To assess mid-term outcome of biodegradable biliary stents (BBSs) to treat benign biliary strictures refractory to standard bilioplasty. METHODS: Institutional review board approval was obtained and patient consent was waived. 107 patients (61 males, 46 females, mean age 59 ± 16 years), were treated. Technical success and complications were recorded. Ninety-seven patients (55 males, 42 females, aged 57 ± 17 years) were considered for follow-up analysis (mean follow-up 23 ± 12 months). Fisher's exact test and Mann-Whitney U tests were used and a Kaplan-Meier curve was calculated. RESULTS: The procedure was always feasible. In 2/107 cases (2 %), stent migration occurred (technical success 98 %). 4/107 patients (4 %) experienced mild haemobilia. No major complications occurred. In 19/97 patients (18 %), stricture recurrence occurred. In this group, higher rate of subsequent cholangitis (84.2 % vs. 12.8 %, p = 0.001) and biliary stones (26.3 % vs. 2.5 %, p = 0.003) was noted. Estimated mean time to stricture recurrence was 38 months (95 % C.I 34-42 months). Estimated stricture recurrence rate at 1, 2, and 3 years was respectively 7.2 %, 26.4 %, and 29.4 %. CONCLUSION: Percutaneous placement of a BBS is a feasible and safe strategy to treat benign biliary strictures refractory to standard bilioplasty, with promising results in the mid-term period. KEY POINTS: • Percutaneous placement of a BBS is 100 % feasible. • The procedure appears free from major complications, with few minor complications. • BBSs offer promising results in the mid-term period. • With a BBS, external catheter/drainage can be removed early. • BBSs represent a new option in treating benign biliary stenosis.
OBJECTIVES: To assess mid-term outcome of biodegradable biliary stents (BBSs) to treat benign biliary strictures refractory to standard bilioplasty. METHODS: Institutional review board approval was obtained and patient consent was waived. 107 patients (61 males, 46 females, mean age 59 ± 16 years), were treated. Technical success and complications were recorded. Ninety-seven patients (55 males, 42 females, aged 57 ± 17 years) were considered for follow-up analysis (mean follow-up 23 ± 12 months). Fisher's exact test and Mann-Whitney U tests were used and a Kaplan-Meier curve was calculated. RESULTS: The procedure was always feasible. In 2/107 cases (2 %), stent migration occurred (technical success 98 %). 4/107 patients (4 %) experienced mild haemobilia. No major complications occurred. In 19/97 patients (18 %), stricture recurrence occurred. In this group, higher rate of subsequent cholangitis (84.2 % vs. 12.8 %, p = 0.001) and biliary stones (26.3 % vs. 2.5 %, p = 0.003) was noted. Estimated mean time to stricture recurrence was 38 months (95 % C.I 34-42 months). Estimated stricture recurrence rate at 1, 2, and 3 years was respectively 7.2 %, 26.4 %, and 29.4 %. CONCLUSION: Percutaneous placement of a BBS is a feasible and safe strategy to treat benign biliary strictures refractory to standard bilioplasty, with promising results in the mid-term period. KEY POINTS: • Percutaneous placement of a BBS is 100 % feasible. • The procedure appears free from major complications, with few minor complications. • BBSs offer promising results in the mid-term period. • With a BBS, external catheter/drainage can be removed early. • BBSs represent a new option in treating benign biliary stenosis.
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