BACKGROUND AND AIM: Management of benign biliary stricture is challenging. Endoscopic therapy has evolved as the first-line treatment for various benign biliary strictures. However, covered self-expandable metal stents (CSEMS) have not been approved by the United States Food and Drug Administration for the treatment of benign biliary stricture. With this goal, we conducted the present systemic review and meta-analysis to evaluate the efficacy and safety of endoscopic stenting with CSEMS in the treatment of benign biliary stricture. METHODS: Systematic review and meta-analysis by searching PubMed, MEDLINE and Embase databases. RESULTS: In total, 37 studies (1677 patients) fulfilled the inclusion criteria. Pooled stricture resolutions were achieved in 83% of cases. Median stent dwelling time was 4.4 months, with median endoscopic retrograde cholangiopancreatography sessions of 2.0. Stricture recurrence at 4-year follow up was 11% (95% CI, 8-14%). Pooled complication rate was 23% (95% CI, 20-26%). CONCLUSIONS: Placement of CSEMS is effective in the treatment of benign biliary stricture with relatively short stenting duration and low long-term stricture recurrence rate. However, more prospectively randomized studies are required to confirm the results.
BACKGROUND AND AIM: Management of benign biliary stricture is challenging. Endoscopic therapy has evolved as the first-line treatment for various benign biliary strictures. However, covered self-expandable metal stents (CSEMS) have not been approved by the United States Food and Drug Administration for the treatment of benign biliary stricture. With this goal, we conducted the present systemic review and meta-analysis to evaluate the efficacy and safety of endoscopic stenting with CSEMS in the treatment of benign biliary stricture. METHODS: Systematic review and meta-analysis by searching PubMed, MEDLINE and Embase databases. RESULTS: In total, 37 studies (1677 patients) fulfilled the inclusion criteria. Pooled stricture resolutions were achieved in 83% of cases. Median stent dwelling time was 4.4 months, with median endoscopic retrograde cholangiopancreatography sessions of 2.0. Stricture recurrence at 4-year follow up was 11% (95% CI, 8-14%). Pooled complication rate was 23% (95% CI, 20-26%). CONCLUSIONS: Placement of CSEMS is effective in the treatment of benign biliary stricture with relatively short stenting duration and low long-term stricture recurrence rate. However, more prospectively randomized studies are required to confirm the results.
Authors: Wafaa Ahmed; Dave Kyle; Amardeep Khanna; John Devlin; David Reffitt; Zeino Zeino; George Webster; Simon Phillpotts; Robert Gordon; Gareth Corbett; William Gelson; Manu Nayar; Haider Khan; Matthew Cramp; Jonathan Potts; Waleed Fateen; Hamish Miller; Bharat Paranandi; Matthew Huggett; Simon M Everett; Vinod S Hegade; Rebecca O'Kane; Ryan Scott; Neil McDougall; Phillip Harrison; Deepak Joshi Journal: Therap Adv Gastroenterol Date: 2022-09-26 Impact factor: 4.802