title: Long-term follow-up after biliary stent placement for postcholecystectomy bile duct strictures: a multicenter study.
abstract: OBJECTIVE
  Endoscopic stenting is a recognized treatment of postcholecystectomy biliary strictures. Large multicenter reports of its long-term efficacy are lacking. Our aim was to analyze the long-term outcomes after stenting in this patient population, based on a large experience from several centers in France.
  
  
  METHODS
  Members of the French Society of Digestive Endoscopy were asked to identify patients treated for a common bile duct postcholecystectomy stricture. Patients with successful stenting and follow-up after removal of stent(s) were subsequently included and analyzed. Main outcome measures were long-term success of endoscopic stenting and related predictors for recurrence (after one stenting period) or failure (at the end of follow-up).
  
  
  RESULTS
  A total of 96 patients were eligible for inclusion. The mean number of stents inserted at the same time was 1.9±0.89 (range 1-4). Stent-related morbidity was 22.9% (n=22). The median duration of stenting was 12 months (range 2-96 months). After a mean follow-up of 6.4±3.8 years (range 0-20.3 years) the overall success rate was 66.7% (n=64) after one period of stenting and 82.3% (n=79) after additional treatments. The mean time to recurrence was 19.7±36.6 months. The most significant independent predictor of both recurrence and failure was a pathological cholangiography at the time of stent removal.
  
  
  CONCLUSIONS
  Endoscopic stenting helps to avoid surgery in more than 80% of patients bearing postcholecystectomy common bile duct strictures. However, a persistent anomaly on cholangiography at the time of stent removal is a strong predictor of recurrence and may lead to consideration of surgery.
authors.affiliation: Gastroenterology Department, Cochin Hospital, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Tuvignon
authors.forename: C
authors.initials: C
authors.lastname: Liguory
authors.forename: T
authors.initials: T
authors.lastname: Ponchon
authors.forename: B
authors.initials: B
authors.lastname: Meduri
authors.forename: J
authors.initials: J
authors.lastname: Fritsch
authors.forename: J
authors.initials: J
authors.lastname: Sahel
authors.forename: J
authors.initials: J
authors.lastname: Boyer
authors.forename: J L
authors.initials: JL
authors.lastname: Legoux
authors.forename: J
authors.initials: J
authors.lastname: Escourrou
authors.forename: C
authors.initials: C
authors.lastname: Boustiere
authors.forename: J P
authors.initials: JP
authors.lastname: Arpurt
authors.forename: M
authors.initials: M
authors.lastname: Barthet
authors.forename: P
authors.initials: P
authors.lastname: Tuvignon
authors.forename: G
authors.initials: G
authors.lastname: Bommelaer
authors.forename: B
authors.initials: B
authors.lastname: Ducot
authors.forename: F
authors.initials: F
authors.lastname: Prat
mesh_terms: D001652:Bile Ducts / Q000473:pathology*; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy / Q000009:adverse effects*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome