Ulriikka Chaput1, Ariane Vienne1, Etienne Audureau2, Paul Bauret3, Philippe Bichard4, Dimitri Coumaros5, Bertrand Napoléon6, Thierry Ponchon7, Jean-Christophe Duchmann8, René Laugier9, Hervé Lamouliatte10, Bruno Védrenne11, Marianne Gaudric1, Stanislas Chaussade12, Françoise Robin13, Sarah Leblanc1, Frédéric Prat12. 1. Gastroenterology Department, Cochin Hospital, Paris, France. 2. Public Health Department, Henri Mondor Hospital, LIC EA4393 Paris Est Créteil University (UPEC), Paris, France. 3. Gastroenterology Department, Saint Eloi Hospital, Montpellier, France. 4. Gastroenterology Department, La Tronche Hospital, Grenoble, France. 5. Gastroenterology Department, Civil Hospital of Strasbourg, Strasbourg, France. 6. Gastroenterology Department, Private Hospital Jean Mermoz, Lyon, France. 7. Gastroenterology Department, Edouard Herriot Hospital, Lyon, France. 8. Gastroenterology Department, Hospital of Compiègne, Compiègne, France. 9. Gastroenterology Department, La Timone Hospital, Marseille, France. 10. Gastroenterology Department, Saint-André Hospital, Bordeaux, France. 11. Gastroenterology Department, Emile Muller Hospital, Mulhouse, France. 12. Gastroenterology Department, Cochin Hospital, Paris, France; Paris-Descartes University, Paris, France. 13. French Society of Digestive Endoscopy, Lyon and Paris, France.
Abstract
BACKGROUND: Endoscopic treatment of benign biliary strictures (BBS) can be challenging. OBJECTIVE: To evaluate the efficacy of fully covered self-expandable metal stents (FCSEMS) in BBS. METHODS: Ninety-two consecutive patients with BBS (chronic pancreatitis (n = 42), anastomotic after liver transplantation (n = 36), and post biliary surgical procedure (n = 14)) were included. FCSEMS were placed across strictures for 6 months before endoscopic extraction. Early success rate was defined as the absence of biliary stricture or as a minimal residual anomaly on post-stent removal endoscopic retrograde cholangiopancreatography (ERCP). Secondary outcomes were the final success and stricture recurrence rates as well as procedure-related morbidity. RESULTS: Stenting was successful in all patients. Stenting associated complications were minor and occurred in 22 (23.9%) patients. Migration occurred in 23 (25%) patients. Stent extraction was successful in all but two patients with proximal stent migration. ERCP after the 6 months stenting showed an early success in 84.9% patients (chronic pancreatitis patients: 94.7%, liver transplant: 87.9%, post-surgical: 61.5%) (p = 0.01). Final success was observed in 57/73 (78.1%) patients with a median follow-up of 12 ± 3.56 months. Recurrence of biliary stricture occurred in 16/73 (21.9%) patients. CONCLUSIONS: FCSEMS placement is efficient for patients with BBS, in particular for chronic pancreatitis patients. Stent extraction after 6 months indwelling, although generally feasible, may fail in a few cases.
BACKGROUND: Endoscopic treatment of benign biliary strictures (BBS) can be challenging. OBJECTIVE: To evaluate the efficacy of fully covered self-expandable metal stents (FCSEMS) in BBS. METHODS: Ninety-two consecutive patients with BBS (chronic pancreatitis (n = 42), anastomotic after liver transplantation (n = 36), and post biliary surgical procedure (n = 14)) were included. FCSEMS were placed across strictures for 6 months before endoscopic extraction. Early success rate was defined as the absence of biliary stricture or as a minimal residual anomaly on post-stent removal endoscopic retrograde cholangiopancreatography (ERCP). Secondary outcomes were the final success and stricture recurrence rates as well as procedure-related morbidity. RESULTS: Stenting was successful in all patients. Stenting associated complications were minor and occurred in 22 (23.9%) patients. Migration occurred in 23 (25%) patients. Stent extraction was successful in all but two patients with proximal stent migration. ERCP after the 6 months stenting showed an early success in 84.9% patients (chronic pancreatitispatients: 94.7%, liver transplant: 87.9%, post-surgical: 61.5%) (p = 0.01). Final success was observed in 57/73 (78.1%) patients with a median follow-up of 12 ± 3.56 months. Recurrence of biliary stricture occurred in 16/73 (21.9%) patients. CONCLUSIONS: FCSEMS placement is efficient for patients with BBS, in particular for chronic pancreatitispatients. Stent extraction after 6 months indwelling, although generally feasible, may fail in a few cases.
Authors: I Tarantino; M Traina; F Mocciaro; L Barresi; G Curcio; M Di Pisa; A Granata; R Volpes; B Gridelli Journal: Endoscopy Date: 2012-02-21 Impact factor: 10.093
Authors: Jacques Devière; D Nageshwar Reddy; Andreas Püspök; Thierry Ponchon; Marco J Bruno; Michael J Bourke; Horst Neuhaus; André Roy; Ferrán González-Huix Lladó; Alan N Barkun; Paul P Kortan; Claudio Navarrete; Joyce Peetermans; Daniel Blero; Sundeep Lakhtakia; Werner Dolak; Vincent Lepilliez; Jan W Poley; Andrea Tringali; Guido Costamagna Journal: Gastroenterology Date: 2014-05-04 Impact factor: 22.682
Authors: N Tuvignon; C Liguory; T Ponchon; B Meduri; J Fritsch; J Sahel; J Boyer; J L Legoux; J Escourrou; C Boustiere; J P Arpurt; M Barthet; P Tuvignon; G Bommelaer; B Ducot; F Prat Journal: Endoscopy Date: 2011-03-01 Impact factor: 10.093
Authors: Marc F Catalano; Jeffrey D Linder; Suku George; Eduardo Alcocer; Joseph E Geenen Journal: Gastrointest Endosc Date: 2004-12 Impact factor: 9.427
Authors: Michel Kahaleh; Alan Brijbassie; Amrita Sethi; Marisa Degaetani; John M Poneros; David E Loren; Thomas E Kowalski; Divyesh V Sejpal; Sandeep Patel; Laura Rosenkranz; Kevin N McNamara; Isaac Raijman; Jayant P Talreja; Monica Gaidhane; Bryan G Sauer; Peter D Stevens Journal: J Clin Gastroenterol Date: 2013-09 Impact factor: 3.062
Authors: Chang-Il Kwon; Jae Hee Cho; Sung Hoon Choi; Kwang Hyun Ko; Temel Tirkes; Mark A Gromski; Glen A Lehman Journal: Korean J Intern Med Date: 2019-02-25 Impact factor: 2.884
Authors: Jong Jin Hyun; Shayan S Irani; Andrew S Ross; Michael C Larsen; Michael Gluck; Richard A Kozarek Journal: Gut Liver Date: 2021-01-15 Impact factor: 4.519