title: Placement of a new fully covered self-expanding metal stent for postoperative biliary strictures and leaks not responding to plastic stenting.
abstract: Fully covered self-expanding metal stents (FCSEMSs) are now being used to treat postoperative biliary strictures (BSs) and biliary leaks (BLs). The aim of this study was to assess the safety and effectiveness of a new FCSEMS (Wallflex) in patients with postoperative BSs and BLs after failure of traditional endoscopic treatment. Between January 2010 and December 2011, 16 patients (10 patients with postcholecystectomy BSs, 4 with postcholecystectomy BLs, and 2 with postorthotopic liver transplantation BSs) were enrolled. The technical and clinical success rate was 100%. All FCSEMSs were removed after a mean of 141 days. Complications occurred in 7 cases: 2 postprocedure pain, 2 mild pancreatitis, 1 early distal, and 2 late proximal FCSEMS migration. The overall long-term clinical success rate was 94% after a mean follow-up of 13 months. In our experience, the placement of FCSEMSs is an effective and secure method of treating refractory postoperative BSs or BLs.
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria Hospital, Bologna, Italy. carmeluigiano@libero.it
authors.forename: Carmelo
authors.initials: C
authors.lastname: Luigiano
authors.forename: Marco
authors.initials: M
authors.lastname: Bassi
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferrara
authors.forename: Carlo
authors.initials: C
authors.lastname: Fabbri
authors.forename: Stefania
authors.initials: S
authors.lastname: Ghersi
authors.forename: Carmela
authors.initials: C
authors.lastname: Morace
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Consolo
authors.forename: Antonella
authors.initials: A
authors.lastname: Maimone
authors.forename: Gabriella
authors.initials: G
authors.lastname: Galluccio
authors.forename: Nicola
authors.initials: N
authors.lastname: D'Imperio
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cennamo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000000981:diagnostic imaging / Q000601:surgery*; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008670:Metals; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents; D016896:Treatment Outcome
chemical_list: D008670:Metals