title: Use of fully covered self-expanding metal stents for the management of benign biliary conditions.
abstract: OBJECTIVE
  biliary self-expanding metal stents (SEMS) have the advantage of being inserted undeployed with very small sizes and provide, when fully opened, large diameters for biliary drainage. However, their use in benign conditions has been very limited, mainly because of difficulty in their extraction. We present our initial experience with a fully covered SEMS (Wallflex) for the management of benign problems of the bile duct.
  
  
  METHODS
  in a prospective study, stents of 8 mm in diameter and 4, 6 or 8 cm long were inserted by means of ERCP. These SEMS were chosen when according to medical judgement it was thought that diameters greater than 10 French (3.3 mm) were needed for proper biliary drainage. Stents were extracted also endoscopically, several months later when deemed clinically appropriate.
  
  
  RESULTS
  twenty biliary SEMS were inserted. Reasons for insertion were: large intrahepatic biliary fistula after hydatid cyst surgery (1), perforation of the papillary area following endoscopic sphincterotomy (2), coaxial insertion to achieve patency in obstructed uncovered stents inserted in benign conditions (3), benign strictures (7), multiple and large common bile duct stones that could not be extracted because of tapering and stricturing of the distal common bile duct (7). In all cases, successful biliary drainage was achieved and there were no complications from insertion. Stents were easily extracted after a mean time of 132 days (36-270) in place. Complete resolution of biliary problems was obtained in 14 patients (70%).
  
  
  CONCLUSIONS
  in our initial experience, the fully covered Wallflex biliary stent was removed without any complication after being in place in the common bile duct for a mean time of over four months. Therefore, it could be used in the management of benign biliary conditions.
authors.affiliation: Department of Digestive Diseases, Hospital Virgen de la Luz, Cuenca, Spain. j.garcia-cano@terra.es
authors.forename: J
authors.initials: J
authors.lastname: García-Cano
authors.forename: L
authors.initials: L
authors.lastname: Taberna-Arana
authors.forename: C
authors.initials: C
authors.lastname: Jimeno-Ayllón
authors.forename: R
authors.initials: R
authors.lastname: Martínez-Fernández
authors.forename: L
authors.initials: L
authors.lastname: Serrano-Sánchez
authors.forename: A K
authors.initials: AK
authors.lastname: Reyes-Guevara
authors.forename: M
authors.initials: M
authors.lastname: Viñuelas-Chicano
authors.forename: C J
authors.initials: CJ
authors.lastname: Gómez-Ruiz
authors.forename: M J
authors.initials: MJ
authors.lastname: Morillas-Ariño
authors.forename: J I
authors.initials: JI
authors.lastname: Pérez-García
authors.forename: G
authors.initials: G
authors.lastname: Pérez-Vigara
authors.forename: A
authors.initials: A
authors.lastname: Pérez-Sola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D015607:Stents