Benign biliary strictures refractory to standard bilioplasty treated using polydoxanone biodegradable biliary stents

retrospective multicentric data analysis on 107 patients

Giovanni Mauri, Caterina Michelozzi, Fabio Melchiorre, Dario Poretti, Vittorio Pedicini, Monica Salvetti, Eva Criado, Joan Falcò Fages, Miguel Ángel de Gregorio, Alicia Laborda, Luca Maria Sconfienza, Gian Paolo Cornalba, Lorenzo Monfardini, Jiri Panek, Andrasina Tomas, Mariano Gimenez

Research output: Contribution to journalArticle

Abstract

Objectives: To assess mid-term outcome of biodegradable biliary stents (BBSs) to treat benign biliary strictures refractory to standard bilioplasty. Methods: Institutional review board approval was obtained and patient consent was waived. 107 patients (61 males, 46 females, mean age 59 ± 16 years), were treated. Technical success and complications were recorded. Ninety-seven patients (55 males, 42 females, aged 57 ± 17 years) were considered for follow-up analysis (mean follow-up 23 ± 12 months). Fisher’s exact test and Mann–Whitney U tests were used and a Kaplan–Meier curve was calculated. Results: The procedure was always feasible. In 2/107 cases (2 %), stent migration occurred (technical success 98 %). 4/107 patients (4 %) experienced mild haemobilia. No major complications occurred. In 19/97 patients (18 %), stricture recurrence occurred. In this group, higher rate of subsequent cholangitis (84.2 % vs. 12.8 %, p = 0.001) and biliary stones (26.3 % vs. 2.5 %, p = 0.003) was noted. Estimated mean time to stricture recurrence was 38 months (95 % C.I 34–42 months). Estimated stricture recurrence rate at 1, 2, and 3 years was respectively 7.2 %, 26.4 %, and 29.4 %. Conclusion: Percutaneous placement of a BBS is a feasible and safe strategy to treat benign biliary strictures refractory to standard bilioplasty, with promising results in the mid-term period. Key Points: • Percutaneous placement of a BBS is 100 % feasible. • The procedure appears free from major complications, with few minor complications. • BBSs offer promising results in the mid-term period. • With a BBS, external catheter/drainage can be removed early. • BBSs represent a new option in treating benign biliary stenosis.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalEuropean Radiology
DOIs
Publication statusAccepted/In press - Mar 4 2016

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Stents
Pathologic Constriction
Recurrence
Hemobilia
Cholangitis
Research Ethics Committees
Drainage
Catheters

Keywords

  • Biliary stricture
  • Bioabsorbable biliary stent
  • Percutaneous transhepatic bilioplasty
  • Percutaneous transhepatic cholangiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Benign biliary strictures refractory to standard bilioplasty treated using polydoxanone biodegradable biliary stents : retrospective multicentric data analysis on 107 patients. / Mauri, Giovanni; Michelozzi, Caterina; Melchiorre, Fabio; Poretti, Dario; Pedicini, Vittorio; Salvetti, Monica; Criado, Eva; Falcò Fages, Joan; de Gregorio, Miguel Ángel; Laborda, Alicia; Sconfienza, Luca Maria; Cornalba, Gian Paolo; Monfardini, Lorenzo; Panek, Jiri; Tomas, Andrasina; Gimenez, Mariano.

In: European Radiology, 04.03.2016, p. 1-7.

Research output: Contribution to journalArticle

Mauri, G, Michelozzi, C, Melchiorre, F, Poretti, D, Pedicini, V, Salvetti, M, Criado, E, Falcò Fages, J, de Gregorio, MÁ, Laborda, A, Sconfienza, LM, Cornalba, GP, Monfardini, L, Panek, J, Tomas, A & Gimenez, M 2016, 'Benign biliary strictures refractory to standard bilioplasty treated using polydoxanone biodegradable biliary stents: retrospective multicentric data analysis on 107 patients', European Radiology, pp. 1-7. https://doi.org/10.1007/s00330-016-4278-6
Mauri, Giovanni ; Michelozzi, Caterina ; Melchiorre, Fabio ; Poretti, Dario ; Pedicini, Vittorio ; Salvetti, Monica ; Criado, Eva ; Falcò Fages, Joan ; de Gregorio, Miguel Ángel ; Laborda, Alicia ; Sconfienza, Luca Maria ; Cornalba, Gian Paolo ; Monfardini, Lorenzo ; Panek, Jiri ; Tomas, Andrasina ; Gimenez, Mariano. / Benign biliary strictures refractory to standard bilioplasty treated using polydoxanone biodegradable biliary stents : retrospective multicentric data analysis on 107 patients. In: European Radiology. 2016 ; pp. 1-7.
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abstract = "Objectives: To assess mid-term outcome of biodegradable biliary stents (BBSs) to treat benign biliary strictures refractory to standard bilioplasty. Methods: Institutional review board approval was obtained and patient consent was waived. 107 patients (61 males, 46 females, mean age 59 ± 16 years), were treated. Technical success and complications were recorded. Ninety-seven patients (55 males, 42 females, aged 57 ± 17 years) were considered for follow-up analysis (mean follow-up 23 ± 12 months). Fisher’s exact test and Mann–Whitney U tests were used and a Kaplan–Meier curve was calculated. Results: The procedure was always feasible. In 2/107 cases (2 {\%}), stent migration occurred (technical success 98 {\%}). 4/107 patients (4 {\%}) experienced mild haemobilia. No major complications occurred. In 19/97 patients (18 {\%}), stricture recurrence occurred. In this group, higher rate of subsequent cholangitis (84.2 {\%} vs. 12.8 {\%}, p = 0.001) and biliary stones (26.3 {\%} vs. 2.5 {\%}, p = 0.003) was noted. Estimated mean time to stricture recurrence was 38 months (95 {\%} C.I 34–42 months). Estimated stricture recurrence rate at 1, 2, and 3 years was respectively 7.2 {\%}, 26.4 {\%}, and 29.4 {\%}. Conclusion: Percutaneous placement of a BBS is a feasible and safe strategy to treat benign biliary strictures refractory to standard bilioplasty, with promising results in the mid-term period. Key Points: • Percutaneous placement of a BBS is 100 {\%} feasible. • The procedure appears free from major complications, with few minor complications. • BBSs offer promising results in the mid-term period. • With a BBS, external catheter/drainage can be removed early. • BBSs represent a new option in treating benign biliary stenosis.",
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T2 - retrospective multicentric data analysis on 107 patients

AU - Mauri, Giovanni

AU - Michelozzi, Caterina

AU - Melchiorre, Fabio

AU - Poretti, Dario

AU - Pedicini, Vittorio

AU - Salvetti, Monica

AU - Criado, Eva

AU - Falcò Fages, Joan

AU - de Gregorio, Miguel Ángel

AU - Laborda, Alicia

AU - Sconfienza, Luca Maria

AU - Cornalba, Gian Paolo

AU - Monfardini, Lorenzo

AU - Panek, Jiri

AU - Tomas, Andrasina

AU - Gimenez, Mariano

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N2 - Objectives: To assess mid-term outcome of biodegradable biliary stents (BBSs) to treat benign biliary strictures refractory to standard bilioplasty. Methods: Institutional review board approval was obtained and patient consent was waived. 107 patients (61 males, 46 females, mean age 59 ± 16 years), were treated. Technical success and complications were recorded. Ninety-seven patients (55 males, 42 females, aged 57 ± 17 years) were considered for follow-up analysis (mean follow-up 23 ± 12 months). Fisher’s exact test and Mann–Whitney U tests were used and a Kaplan–Meier curve was calculated. Results: The procedure was always feasible. In 2/107 cases (2 %), stent migration occurred (technical success 98 %). 4/107 patients (4 %) experienced mild haemobilia. No major complications occurred. In 19/97 patients (18 %), stricture recurrence occurred. In this group, higher rate of subsequent cholangitis (84.2 % vs. 12.8 %, p = 0.001) and biliary stones (26.3 % vs. 2.5 %, p = 0.003) was noted. Estimated mean time to stricture recurrence was 38 months (95 % C.I 34–42 months). Estimated stricture recurrence rate at 1, 2, and 3 years was respectively 7.2 %, 26.4 %, and 29.4 %. Conclusion: Percutaneous placement of a BBS is a feasible and safe strategy to treat benign biliary strictures refractory to standard bilioplasty, with promising results in the mid-term period. Key Points: • Percutaneous placement of a BBS is 100 % feasible. • The procedure appears free from major complications, with few minor complications. • BBSs offer promising results in the mid-term period. • With a BBS, external catheter/drainage can be removed early. • BBSs represent a new option in treating benign biliary stenosis.

AB - Objectives: To assess mid-term outcome of biodegradable biliary stents (BBSs) to treat benign biliary strictures refractory to standard bilioplasty. Methods: Institutional review board approval was obtained and patient consent was waived. 107 patients (61 males, 46 females, mean age 59 ± 16 years), were treated. Technical success and complications were recorded. Ninety-seven patients (55 males, 42 females, aged 57 ± 17 years) were considered for follow-up analysis (mean follow-up 23 ± 12 months). Fisher’s exact test and Mann–Whitney U tests were used and a Kaplan–Meier curve was calculated. Results: The procedure was always feasible. In 2/107 cases (2 %), stent migration occurred (technical success 98 %). 4/107 patients (4 %) experienced mild haemobilia. No major complications occurred. In 19/97 patients (18 %), stricture recurrence occurred. In this group, higher rate of subsequent cholangitis (84.2 % vs. 12.8 %, p = 0.001) and biliary stones (26.3 % vs. 2.5 %, p = 0.003) was noted. Estimated mean time to stricture recurrence was 38 months (95 % C.I 34–42 months). Estimated stricture recurrence rate at 1, 2, and 3 years was respectively 7.2 %, 26.4 %, and 29.4 %. Conclusion: Percutaneous placement of a BBS is a feasible and safe strategy to treat benign biliary strictures refractory to standard bilioplasty, with promising results in the mid-term period. Key Points: • Percutaneous placement of a BBS is 100 % feasible. • The procedure appears free from major complications, with few minor complications. • BBSs offer promising results in the mid-term period. • With a BBS, external catheter/drainage can be removed early. • BBSs represent a new option in treating benign biliary stenosis.

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KW - Bioabsorbable biliary stent

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KW - Percutaneous transhepatic cholangiography

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