TY - JOUR
T1 - Intraductal fully covered self-expandable metal stent versus multiple plastic stents for treating biliary anastomotic strictures after liver transplantation
AU - Sissingh, Noor J.
AU - de Vries, Boudewijn A.
AU - Inderson, Akin
AU - van Hoek, Bart
AU - van der Heide, Frans
AU - van Hooft, Jeanin E.
N1 - Funding Information:
DISCLOSURE: Dr Inderson is a consultant for Cook Medical and Olympia and the recipient of research support from Prion Medical. Dr van Hoek received research support from Chiesi and Sandoz, and educational support from Norgine and Abacus Medicine. Dr van Hooft is a consultant for Cook Medical, Boston Scientific, Olympus, Medtronic, and Abbvie, and the recipient of research support from Cook Medical. All other authors disclosed no financial relationships.
Funding Information:
Disclosure: Dr Inderson is a consultant for Cook Medical and Olympia and the recipient of research support from Prion Medical. Dr van Hoek received research support from Chiesi and Sandoz, and educational support from Norgine and Abacus Medicine. Dr van Hooft is a consultant for Cook Medical, Boston Scientific, Olympus, Medtronic, and Abbvie, and the recipient of research support from Cook Medical. All other authors disclosed no financial relationships.
Publisher Copyright:
© 2023 American Society for Gastrointestinal Endoscopy
PY - 2023/4
Y1 - 2023/4
N2 - Background and aims: Fully covered metal stents (FCSEMSs) are increasingly used for treatment of biliary anastomotic strictures (ASs) after liver transplantation (LT), requiring fewer endoscopic interventions than does treatment with multiple plastic stents (MPSs). Previous studies, however, have reported adverse events such as stent migration and pancreatitis. The intraductal FCSEMS (ID-FCSEMS) potentially avoids these disadvantages. This study aimed to assess the efficacy and safety of ID-FCSEMSs compared with MPSs for AS. Methods: The cohorts of LT patients treated for AS with endoscopic stenting between 2010 and 2019 from 2 Dutch liver transplantation centers were retrospectively analyzed. Patients treated with ID-FCSEMSs or MPSs were included. Results: 80 patients (44 with ID-FCSEMSs vs 36 with MPSs) were included, with a median follow-up time of 52 versus 64 months (P = .183). Stricture resolution was 93% in the ID-FCSEMS versus 97% in the MPS group (P = 1.000) after a median of 19 and 26 weeks, respectively (P = .031). The median number of ERCPs was 2 in the ID-FCSEMS group versus 4 in the MPS group (P < .001). Stricture recurrence occurred in 33% of ID-FCSEMS versus 29% of MPS patients (P = .653) after a median of 24 and 55 weeks (P = .403). Stent migration occurred in 16% of ID-FCSEMS versus 39% of MPS patients (P = .020). Post-ERCP fever was observed in 34% of ID-FCSEMS patients compared with 14% of MPS patients (P = .038). No significant differences were found in pancreatitis rate between the groups, being 6.8% for ID-FCSEMSs and 5.6% for MPSs (P = .816). Conclusion: ID-FCSEMSs for the treatment of AS after LT provides similar stricture resolution and recurrence rates as MPSs, though with a significant reduction of procedures needed.
AB - Background and aims: Fully covered metal stents (FCSEMSs) are increasingly used for treatment of biliary anastomotic strictures (ASs) after liver transplantation (LT), requiring fewer endoscopic interventions than does treatment with multiple plastic stents (MPSs). Previous studies, however, have reported adverse events such as stent migration and pancreatitis. The intraductal FCSEMS (ID-FCSEMS) potentially avoids these disadvantages. This study aimed to assess the efficacy and safety of ID-FCSEMSs compared with MPSs for AS. Methods: The cohorts of LT patients treated for AS with endoscopic stenting between 2010 and 2019 from 2 Dutch liver transplantation centers were retrospectively analyzed. Patients treated with ID-FCSEMSs or MPSs were included. Results: 80 patients (44 with ID-FCSEMSs vs 36 with MPSs) were included, with a median follow-up time of 52 versus 64 months (P = .183). Stricture resolution was 93% in the ID-FCSEMS versus 97% in the MPS group (P = 1.000) after a median of 19 and 26 weeks, respectively (P = .031). The median number of ERCPs was 2 in the ID-FCSEMS group versus 4 in the MPS group (P < .001). Stricture recurrence occurred in 33% of ID-FCSEMS versus 29% of MPS patients (P = .653) after a median of 24 and 55 weeks (P = .403). Stent migration occurred in 16% of ID-FCSEMS versus 39% of MPS patients (P = .020). Post-ERCP fever was observed in 34% of ID-FCSEMS patients compared with 14% of MPS patients (P = .038). No significant differences were found in pancreatitis rate between the groups, being 6.8% for ID-FCSEMSs and 5.6% for MPSs (P = .816). Conclusion: ID-FCSEMSs for the treatment of AS after LT provides similar stricture resolution and recurrence rates as MPSs, though with a significant reduction of procedures needed.
U2 - 10.1016/j.gie.2022.11.018
DO - 10.1016/j.gie.2022.11.018
M3 - Article
C2 - 36460088
AN - SCOPUS:85148770581
SN - 0016-5107
VL - 97
SP - 704-712.e2
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 4
ER -