title: Covered metal stents in endoscopic therapy of biliary complications after liver transplantation.
abstract: There is growing interest in using covered self-expandable metal stents for the treatment of benign biliary conditions, and the presence of anastomotic biliary strictures and leaks after liver transplantation provide a valuable opportunity for testing them. The performance of the stents is encouraging, and the technical success rate is high. They provide larger diameter dilation and are easily removed, and can potentially limit costs by reducing the number of procedures needed to treat anastomotic biliary strictures. However, drawbacks such as sub-optimal tolerability and migration may affect both patient management and costs. New stent designs are currently being evaluated. Randomized controlled trials and cost-effectiveness analyses comparing covered metal stents with multiple plastic stent endotherapy are warranted in order to define the role of the former as first-line or rescue treatment.
authors.affiliation: Gastroenterology and Endoscopy Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cantù
authors.affiliation: Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tenca
authors.affiliation: Gastroenterology and Endoscopy Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Parzanese
authors.affiliation: Gastroenterology and Endoscopy Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy. Electronic address: roberto.penagini@unimi.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Penagini
mesh_terms: D057868:Anastomotic Leak / Q000209:etiology / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000379:methods*; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology; D004867:Equipment Design; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008670:Metals; D011183:Postoperative Complications / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D015607:Stents / Q000706:statistics & numerical data*
chemical_list: D008670:Metals
keywords: Anastomotic biliary stricture; Biliary leak; ERCP; Endoscopy; Stenting