title: Fully covered self-expandable metal stents for treatment of malignant and benign biliary strictures.
abstract: OBJECTIVE
  To present a series of covered self-expandable metal stents (CSEMS) placed for different indications and to evaluate the effectiveness, complications and extractability of these devices.
  
  
  METHODS
  We therefore retrospectively reviewed the courses of patients who received CSEMS due to malignant as well as benign biliary strictures and post-sphincterotomy bleeding in our endoscopic unit between January 2010 and October 2011.
  
  
  RESULTS
  Twenty-six patients received 28 stents due to different indications (20 stents due to malignant biliary strictures, six stents due to benign biliary strictures and two stents due to post-sphincterotomy bleeding). Biliary obstruction was relieved in all cases, regardless of the underlying cause. Hemostasis could be achieved in the two patients who received the stents for this purpose. Complications occurred in five patients (18%). Two patients (7%) developed cholecystitis, stents dislocated/migrated in other two patients (7%), and in one patient (3.6%) stent occlusion was documented during the study period. Seven stents were extracted endoscopically. Removal of stents was easily possible in all cases in which it was desired using standard forceps. Twelve patients underwent surgery with pylorus preserving duodenopancreatectomy. In all patients stents could be removed during the operation without difficulties.
  
  
  CONCLUSIONS
  Despite the higher costs of these devices, fully covered self-expanding metal stents may be suitable to relief biliary obstruction due to bile duct stenosis, regardless of the underlying cause. CSEMS may also represent an effective treatment strategy of severe post-sphincterotomy bleeding, not controlled by other measures.
authors.affiliation: Ahmed Abdel Samie, Stephan Dette, Ulrich Vöhringer, Karolin Kopischke, Lorenz Theilmann, Department of Gastroenterology, Pforzheim Hospital, Kanzlerstr. 2-6, 75175 Pforzheim, Germany.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdel Samie
authors.forename: Stephan
authors.initials: S
authors.lastname: Dette
authors.forename: Ulrich
authors.initials: U
authors.lastname: Vöhringer
authors.forename: Michael
authors.initials: M
authors.lastname: Stumpf
authors.forename: Karolin
authors.initials: K
authors.lastname: Kopischke
authors.forename: Lorenz
authors.initials: L
authors.lastname: Theilmann
keywords: Biliary stenosis; Completely covered self-expandable metal stents; Pancreatic carcinoma