title: Clinical outcome of single plastic stent treatment of benign iatrogenic biliary strictures: is the outcome predetermined?
abstract: Endoscopic retrograde cholangiopancreatography (ERCP) is used for the management of benign iatrogenic biliary strictures after cholecystectomy and liver transplantation. Multiple stents can injure biliary circulation. If resolution of reversible ductal edema and/or ischemia is the mechanism for successful therapy then single stent placement for benign biliary stricture should work. Retrospectively reviewed ERCP records between November 1999 and 2012 provided 25 patients with repeat ERCPs performed at 10-week intervals or if symptoms of stent occlusion were present. If strictures did not improve between stent changes and if removal was not an option, hepaticojejunostomy was used. Strictures resolved in 72% of patients. Seven patients underwent hepaticojejunostomy. Three had ERCP-related complications. No stricture recurrence occurred during the follow-up period. Endoscopic single plastic stent treatment of benign biliary iatrogenic strictures has comparable success to multiple stenting. Many postsurgical strictures may have reversible ischemic/edematous component with stenting to maintain bile drainage.
authors.affiliation: *Division of Gastroenterology/Hepatology †Department of Internal Medicine, Division of Gastroenterology/Hepatology, University of Iowa Hospitals and Clinics, Iowa City, IA.
authors.forename: Murad A
authors.initials: MA
authors.lastname: Rajab
authors.forename: Jorge
authors.initials: J
authors.lastname: Go
authors.forename: William B
authors.initials: WB
authors.lastname: Silverman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000209:etiology / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007902:Length of Stay / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010969:Plastics / Q000627:therapeutic use; D015607:Stents; D016896:Treatment Outcome
chemical_list: D010969:Plastics