Placement of a new fully covered self-expanding metal stent for postoperative biliary strictures and leaks not responding to plastic stenting

Surg Laparosc Endosc Percutan Tech. 2013 Apr;23(2):159-62. doi: 10.1097/SLE.0b013e318278c201.

Abstract

Fully covered self-expanding metal stents (FCSEMSs) are now being used to treat postoperative biliary strictures (BSs) and biliary leaks (BLs). The aim of this study was to assess the safety and effectiveness of a new FCSEMS (Wallflex) in patients with postoperative BSs and BLs after failure of traditional endoscopic treatment. Between January 2010 and December 2011, 16 patients (10 patients with postcholecystectomy BSs, 4 with postcholecystectomy BLs, and 2 with postorthotopic liver transplantation BSs) were enrolled. The technical and clinical success rate was 100%. All FCSEMSs were removed after a mean of 141 days. Complications occurred in 7 cases: 2 postprocedure pain, 2 mild pancreatitis, 1 early distal, and 2 late proximal FCSEMS migration. The overall long-term clinical success rate was 94% after a mean follow-up of 13 months. In our experience, the placement of FCSEMSs is an effective and secure method of treating refractory postoperative BSs or BLs.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomotic Leak / diagnostic imaging
  • Anastomotic Leak / surgery*
  • Biliary Tract Diseases / diagnostic imaging
  • Biliary Tract Diseases / surgery*
  • Cholecystectomy, Laparoscopic / adverse effects*
  • Cholecystectomy, Laparoscopic / methods
  • Cholestasis / diagnostic imaging
  • Cholestasis / etiology
  • Cholestasis / surgery*
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / methods
  • Male
  • Metals
  • Middle Aged
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery
  • Radiography
  • Reoperation / methods
  • Retrospective Studies
  • Risk Assessment
  • Stents*
  • Treatment Outcome

Substances

  • Metals