title: Self-expanding metallic stent for benign biliary strictures: seven-year follow-up.
abstract: We report two cases of benign biliary strictures managed by metallic stent placement because the patients refused surgical repair. One patient is a 67-year-old man who had a stricture of the right hepatic duct and a bile leak following a cholecystectomy. The second patient is a 50-year-old man who had a stricture of the left hepatic duct following a right hepatic lobectomy for hepatolithiasis. For treatment of these bile duct strictures, a Gianturco-Rosch Z stent was placed in the former case and a Wallstent in the latter. Luminal patency of the stent was maintained for 7 years in the former case but in the latter, luminal stenosis of the stent was induced soon after placement. However, in the former, bile stasis in the left hepatic duct system, which emptied into the side of the stent, gradually developed without signs or symptoms of cholangitis or biliary obstruction. Therefore, the use of metallic stents for benign biliary stricture remains controversial. However, if metallic stent placement is the only therapeutic option, it is necessary to maintain bile flow not only through the stent but also in the bile ducts which flow into the side of the stent.
authors.affiliation: Second Department of Surgery, Osaka City University Medical School, Osaka, Japan. tsukamotot@msic.med.osaka-cu.ac.jp
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirohashi
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Hiromu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hamba
authors.forename: Taichi
authors.initials: T
authors.lastname: Shuto
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D000368:Aged; D002780:Cholestasis, Intrahepatic / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013997:Time Factors