Definitive outcomes of self-expandable metal stents in patients with refractory post-transplant biliary anastomotic stenosis

Ilaria Tarantino, Luca Barresi, Gabriele Curcio, Antonino Granata, Dario Ligresti, Fabio Tuzzolino, Riccardo Volpes, Michele Amata, Mario Traina

Research output: Contribution to journalArticle

Abstract

Background: Endoscopic retrograde cholangio-pancreatography is the gold standard of treatment in patients with biliary complications after liver transplantation. The benefits of fully covered self-expandable metal stents (FCSEMS) lie in their relative simplicity and the need for only two procedures, one for insertion, and the other for removal. Several case series have been published on such stents with generally good outcomes. Objective is to analyze definitive long-term outcomes of this treatment. Methods: Prospective, observational study in a single, tertiary-care referral centre. All consecutive patients with post-transplant biliary stenosis/leak were treated with FCSEMS after failure of conventional treatment. Recurrence was evaluated after four years. Results: From February 2008 to April 2012, 70 patients were included. In all patients, the metal stent was successfully placed. After a mean of 86.7. ± 38.4 days, the stent was removed. Forty-six patients (65.7%) showed resolution. After a mean of 4. ± 1.2 years, 61% of patients maintained the results, but 39% showed recurrence. On the tested variables the diagnosis of stenosis, the number of previous procedures and plastic stents placed correlate with better long-term results. Conclusions: This series suggests a lack of long-term advantages of FCSEMS over plastic stents in the management of biliary stenosis after liver transplantation.

Original languageEnglish
Pages (from-to)562-565
Number of pages4
JournalDigestive and Liver Disease
Volume47
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

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Keywords

  • Biliary leak
  • Biliary stenosis
  • Fully covered self-expandable metal stent
  • Liver transplantation

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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