title: Self expandable metal stents for anastomotic stricture following liver transplant.
abstract: BACKGROUND
  Endoscopic treatment for biliary strictures with plastic stent placement has been used widely. The use of covered self-expandable metal stents (CSEMS) has been reported in anastomotic strictures post liver transplant. The aim of this study was to evaluate the efficacy of different CSEMS in these subjects.
  
  
  METHODS
  A total of 55 patients with anastomotic stricture received CSEMS, which were removed after 3-4 months. There were 19 patients in group A (partially covered SEMS), 21 patients in group B (fully covered SEMS with fins) and 15 patients in group C (fully covered SEMS with flared ends). Technical success, stricture resolution, follows up, and complications were documented.
  
  
  RESULTS
  CSEMS were successfully deployed in all 55 cases. There was no evidence of significant difference with regards to stricture resolution (14 [74%] vs. 15 [71%] vs. 9 [60%] p=0.6630, df=2) or complications between groups. Stent-related complications were as follows: three in group A (2 migration, 1 occlusion), five in group B (4 occlusions, 1 migration), and one proximal migration in group C (p=0.3894, df=2). Three cases required surgery (hepatico-jejunostomy) due to refractory strictures.
  
  
  CONCLUSIONS
  The observed clinical success rate of CSEMS (70.4%) proved to be below the reported one for multiple plastic stents, while no significant differences between CSEMS types were observed.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Cerecedo-Rodriguez
authors.forename: Melissa
authors.initials: M
authors.lastname: Phillips
authors.forename: Paola
authors.initials: P
authors.lastname: Figueroa-Barojas
authors.forename: Sean C
authors.initials: SC
authors.lastname: Kumer
authors.forename: Monica
authors.initials: M
authors.lastname: Gaidhane
authors.forename: Timothy
authors.initials: T
authors.lastname: Schmitt
authors.forename: Michel
authors.initials: M
authors.lastname: Kahaleh
mesh_terms: D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012189:Retrospective Studies; D015607:Stents