Document Detail

Breaking the barrier: using extractable fully covered metal stents to treat benign biliary hilar strictures.
MedLine Citation:
PMID:  21821252     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Most benign biliary strictures nowadays are managed endoscopically with plastic stents or with a insertion of a fully covered self-expandable metal stent (fcSEMS). The paradigm for the treatment of benign hilar strictures precludes the use of an fcSEMS because it obstructs the intrahepatic bile ducts, in particular, the contralateral hepatic duct. It is unknown whether use of a plastic stent in the opposite hepatic duct after deployment of an fcSEMS across the liver hilum provides an adequate solution for this problem.
OBJECTIVE: To evaluate the use of an fcSEMS in combination with a contralateral plastic stent in the treatment of benign hilar strictures.
DESIGN: Case series.
SETTING: Tertiary referral hospital.
PATIENTS: Two consecutive patients with benign hilar strictures.
INTERVENTIONS: Placement of an intrahepatically deployed fcSEMS in conjunction with a contralateral 10F plastic stent for 4 to 5 months followed by stent removal and cholangiogram.
MAIN OUTCOME MEASUREMENTS: Clinical and laboratory follow-up of at least 9 months.
RESULTS: In both patients, the indwelling period of the stents was uneventful as was stent removal. Both strictures resolved, and there were no clinical or biochemical signs of a recurrent stricture.
LIMITATIONS: Small number of patients.
CONCLUSIONS: Treatment of benign hilar strictures with an fcSEMS deployed across the liver hilum in conjunction with a contralateral plastic stent placement is feasible without ensuing cholangitis caused by bile duct occlusion.
Jan-Werner Poley; Antonie J P van Tilburg; Ernst J Kuipers; Marco J Bruno
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2011-08-06
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  74     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-29     Completed Date:  2012-01-23     Revised Date:  2012-03-25    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  916-20     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
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MeSH Terms
Bile Ducts, Intrahepatic*
Cholestasis, Intrahepatic / etiology,  therapy*
Coated Materials, Biocompatible*
Reg. No./Substance:
0/Coated Materials, Biocompatible
Comment In:
Gastrointest Endosc. 2012 Mar;75(3):698-9   [PMID:  22341123 ]

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