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Short fully covered self-expandable metal stent for treatment of proximal anastomotic benign biliary stricture after living-donor liver transplantation

Authors
 Sung Ill Jang  ;  Tae Ryong Chung  ;  Jae Hee Cho  ;  Kwang-Hun Lee  ;  Seung-Moon Joo  ;  Jung Hye Choi  ;  Sae In Kim  ;  Dong Ki Lee 
Citation
 DIGESTIVE ENDOSCOPY, Vol.33(5) : 840-848, 2021-07 
Journal Title
DIGESTIVE ENDOSCOPY
ISSN
 0915-5635 
Issue Date
2021-07
Keywords
anastomoses ; liver transplantation ; postoperative complications ; self-expandable metal stents ; surgical
Abstract
Objectives: Non-surgical methods have high success rates for treating benign biliary strictures (BBSs), but treatment of proximal strictures is difficult. Recent studies have reported that fully covered self-expandable metal stents (FCSEMSs) are useful for treating refractory BBSs. We investigated the efficacy of a short and removable FCSEMS with an anti-migration design for treatment of proximal BBSs.

Methods: Fully covered self-expandable metal stents were inserted endoscopically in patients with BBSs after living donor liver transplantation (LDLT). Each FCSEMS was initially maintained for 3 months and subsequently exchanged every 3 months until the stricture resolved. Adverse events and stricture recurrence after FCSEMS removal were assessed during follow-up.

Results: A total of 63 patients with a median age of 57 years were enrolled in this study; 50 were male. The most common underlying disease was hepatocellular carcinoma and the previous operation was LDLT. The mean duration from surgery to diagnosis of stricture was 8.5 months, and the mean stent indwelling time was 4.2 months. The technical success and stricture resolution rate were 100%. The recurrence rate was 23.8% and the adverse event rate was 12.7%. All stents were removable, and asymptomatic stent migration was observed in four patients (6.4%).

Conclusions: The newly designed FCSEMS is effective in the treatment of proximal BBSs after LDLT.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/den.13871
DOI
10.1111/den.13871
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Kwang Hun(이광훈)
Lee, Dong Ki(이동기) ORCID logo https://orcid.org/0000-0002-0048-9112
Jang, Sung Ill(장성일) ORCID logo https://orcid.org/0000-0003-4937-6167
Cho, Jae Hee(조재희) ORCID logo https://orcid.org/0000-0003-4174-0091
Joo, Seung Moon(주승문) ORCID logo https://orcid.org/0000-0002-0647-2880
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/184269
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