title: Self-expanding metal stents in benign biliary strictures due to chronic pancreatitis.
abstract: OBJECTIVE
  In selected patients with chronic pancreatitis in whom conventional plastic stenting fails and in whom surgery is contraindicated or declined, insertion of a biliary self-expanding metal stent (SEMS) may be a valuable treatment option.
  
  
  METHODS
  Between 1994 and 1999, 13 patients with chronic pancreatitis received SEMS for benign biliary strictures (four women and nine men; mean age 56). The indications for SEMS placement were: contraindication to surgery (n = 10), presumed inoperable pancreatic carcinoma (n = 1), concomitant unresectable lung cancer (n = 1), and declined surgery (n = 1). The success of treatment was defined as adequate biliary drainage due to SEMS therapy.
  
  
  RESULTS
  The mean follow-up period was 50 months (range 6 days - 86 months). Nine patients (69 %) were successfully treated with SEMS therapy: a patent first SEMS (n = 5); a patent second SEMS inserted through the first SEMS (n = 3); and one patent SEMS after balloon cleaning. SEMS treatment was not successful in four patients (due to stent migration in one case and occlusion in three ). The mean patency period of the SEMS was 60 months (95 % CI, 43 months - 77 months). At 33 months, the probability of adequate biliary drainage with SEMS therapy was 75 %.
  
  
  CONCLUSIONS
  SEMS therapy was safe and provided successful and prolonged biliary drainage in a selected group of patients with benign biliary strictures due to chronic pancreatitis in whom surgical intervention was not possible or desirable.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands. a.m.vanberkel@amc.uva.nl
authors.forename: A M
authors.initials: AM
authors.lastname: van Berkel
authors.forename: D L
authors.initials: DL
authors.lastname: Cahen
authors.forename: D J
authors.initials: DJ
authors.lastname: van Westerloo
authors.forename: E A
authors.initials: EA
authors.lastname: Rauws
authors.forename: K
authors.initials: K
authors.lastname: Huibregtse
authors.forename: M J
authors.initials: MJ
authors.lastname: Bruno
mesh_terms: D000328:Adult; D000368:Aged; D002779:Cholestasis / Q000209:etiology* / Q000601:surgery*; D002908:Chronic Disease; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications*; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals