Retrievable biliary stent-graft in the treatment of benign biliary strictures.
OBJECTIVE
To investigate the technical and clinical efficacy of a retrievable stent-graft in the treatment of benign biliary strictures.


METHODS
From February 2004 to December 2006, 29 patients with 32 benign biliary strictures (17 patients with 18 chronic cholangitis strictures and 12 with 14 postoperative strictures) were enrolled in this study. Twenty-four patients had 26 recurrent strictures despite prolonged catheter interposition after balloon dilation procedures. Five patients with six strictures had not previously undergone interventional treatment. A total of 36 stent-grafts were placed, and all stent-grafts were removed by means of a percutaneous route or via a T-tube 6.7 weeks (range, 2-10 weeks) after stent-graft placement.


RESULTS
The retrievable stent-grafts were successfully placed and removed in all cases. Migration occurred in four of the 36 (11%) stent-grafts (11%). Immediately after stent-graft removal, all strictures were widened significantly. From 2 days to 8 weeks after removal, 29 of 32 lesions (91%) remained patent with or without recurrence of minimal strictures. During the mean follow-up of 27.9 months (range, 9-34 months), none of the 29 lesions had recurrence of clinically significant strictures. The primary patency rate was 90.6%. Three additional stent-graft placements for recurrent stricture were required in three lesions (9.4%). During a mean follow-up of 13.3 months (range, 9-16 months), two patients had no evidence of biliary obstruction. The secondary patency rate and clinical success rate was 97% (31 of 32 lesions).


CONCLUSIONS
The placement and removal of a retrievable stent-graft in the treatment of benign biliary strictures is technically feasible and appears to be a clinically effective method.
Gwon
Dong Il
DI
Department of Radiology, Seoul Paik Hospital, University of Inje College of Medicine, 85, Jur-Dong, Jung-Ku, Seoul, 100-032, Korea.
Shim
Hyung Jin
HJ
Kwak
Byung Kook
BK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002779:Cholestasis / Q000601:surgery*; D020878:Device Removal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome