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A New Fully Covered Self-Expandable Metal Stent for the Treatment of Postsurgical Benign Biliary Strictures

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Abstract

Background

Endotherapy with plastic stent (PS) placement is the main modality for treating benign biliary strictures (BBSs). Fully covered self-expandable metal stents (FCSEMSs) are being increasingly used for BBS management, with high stricture resolution. However, traditional metal tents are associated with high migration, causing treatment failure.

Methods

We investigated the efficacy and safety of a new FCSEMS for postsurgical BBS treatment and compared these parameters between the FCSEMS and PS treatment through retrospective analysis. The primary outcome measurements included stricture resolution, stricture recurrence, and complications.

Results

In total, 69 patients were included, of whom 32 underwent FCSEMS treatment and 37 underwent PS treatment. The technical success rate and the number of endoscopic retrograde cholangiopancreatography procedures were similar between the groups. The median stenting duration was 5.2 months (range 1.5–15.3) in the FCSEMS group and 10.7 months (range 2.5–22.6) in the PS group (P < 0.01). The stents removal rate was 96.9% in the FCSEMS group and 94.6% in the PS group. The stricture resolution rate based on intention-to-treat analysis was 83.8% in the PS group and 84.4% (27/32) in the FCSEMS group (P = 0.947), whereas the rates from per-protocol analysis were 88.6% (31/35) and 87.1% (27/31), respectively (P = 0.574). Early and late complications were similar between the groups. The median follow-up time was 43 months (range 13–71). The stricture recurrence rate was 11.1% (3/27) in the FCSEMS group and 16.1% (5/31) in the PS group (P = 0.435).

Conclusions

The new FCSEMS and the PS approach showed similar efficacy and safety in postsurgical BBS treatment. However, the FCSEMS required fewer procedural steps and shorter stenting time, making it an effective alternative modality.

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Author notes

  1. Jun Wu and Dong-xun Zhou contributed equally to this paper.

Authors and Affiliations

  1. Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, 225 Changhai Road, Shanghai, China

    Jun Wu, Dong-xun Zhou, Tian-tian Wang, Dao-jian Gao & Bing Hu

Authors
  1. Jun Wu
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  2. Dong-xun Zhou
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  3. Tian-tian Wang
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  4. Dao-jian Gao
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  5. Bing Hu
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Corresponding author

Correspondence to Bing Hu.

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Conflicts of interest

Jun Wu, Dong-xun Zhou, Tian-tian Wang, Dao-jian Gao, and Bing Hu have no conflicts of interest or financial ties to disclose.

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Wu, J., Zhou, Dx., Wang, Tt. et al. A New Fully Covered Self-Expandable Metal Stent for the Treatment of Postsurgical Benign Biliary Strictures. Dig Dis Sci 62, 2550–2557 (2017). https://doi.org/10.1007/s10620-017-4698-4

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  • DOI: https://doi.org/10.1007/s10620-017-4698-4

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