title: Temporary placement of fully covered self-expandable metal stents for the treatment of benign biliary strictures.
abstract: BACKGROUND
  Endoscopic treatment of benign biliary strictures (BBS) can be challenging.
  
  
  OBJECTIVE
  To evaluate the efficacy of fully covered self-expandable metal stents (FCSEMS) in BBS.
  
  
  METHODS
  Ninety-two consecutive patients with BBS (chronic pancreatitis (n = 42), anastomotic after liver transplantation (n = 36), and post biliary surgical procedure (n = 14)) were included. FCSEMS were placed across strictures for 6 months before endoscopic extraction. Early success rate was defined as the absence of biliary stricture or as a minimal residual anomaly on post-stent removal endoscopic retrograde cholangiopancreatography (ERCP). Secondary outcomes were the final success and stricture recurrence rates as well as procedure-related morbidity.
  
  
  RESULTS
  Stenting was successful in all patients. Stenting associated complications were minor and occurred in 22 (23.9%) patients. Migration occurred in 23 (25%) patients. Stent extraction was successful in all but two patients with proximal stent migration. ERCP after the 6 months stenting showed an early success in 84.9% patients (chronic pancreatitis patients: 94.7%, liver transplant: 87.9%, post-surgical: 61.5%) (p = 0.01). Final success was observed in 57/73 (78.1%) patients with a median follow-up of 12 ± 3.56 months. Recurrence of biliary stricture occurred in 16/73 (21.9%) patients.
  
  
  CONCLUSIONS
  FCSEMS placement is efficient for patients with BBS, in particular for chronic pancreatitis patients. Stent extraction after 6 months indwelling, although generally feasible, may fail in a few cases.
authors.affiliation: Gastroenterology Department, Cochin Hospital, Paris, France.
authors.forename: Ulriikka
authors.initials: U
authors.lastname: Chaput
authors.affiliation: Gastroenterology Department, Cochin Hospital, Paris, France.
authors.forename: Ariane
authors.initials: A
authors.lastname: Vienne
authors.affiliation: Public Health Department, Henri Mondor Hospital, LIC EA4393 Paris Est Créteil University (UPEC), Paris, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Audureau
authors.affiliation: Gastroenterology Department, Saint Eloi Hospital, Montpellier, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Bauret
authors.affiliation: Gastroenterology Department, La Tronche Hospital, Grenoble, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bichard
authors.affiliation: Gastroenterology Department, Civil Hospital of Strasbourg, Strasbourg, France.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Coumaros
authors.affiliation: Gastroenterology Department, Private Hospital Jean Mermoz, Lyon, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Napoléon
authors.affiliation: Gastroenterology Department, Edouard Herriot Hospital, Lyon, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Ponchon
authors.affiliation: Gastroenterology Department, Hospital of Compiègne, Compiègne, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Duchmann
authors.affiliation: Gastroenterology Department, La Timone Hospital, Marseille, France.
authors.forename: René
authors.initials: R
authors.lastname: Laugier
authors.affiliation: Gastroenterology Department, Saint-André Hospital, Bordeaux, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Lamouliatte
authors.affiliation: Gastroenterology Department, Emile Muller Hospital, Mulhouse, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Védrenne
authors.affiliation: Gastroenterology Department, Cochin Hospital, Paris, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Gaudric
authors.affiliation: Gastroenterology Department, Cochin Hospital, Paris, France; Paris-Descartes University, Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
authors.affiliation: French Society of Digestive Endoscopy, Lyon and Paris, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Robin
authors.affiliation: Gastroenterology Department, Cochin Hospital, Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Leblanc
authors.affiliation: Gastroenterology Department, Cochin Hospital, Paris, France; Paris-Descartes University, Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Prat
keywords: Benign biliary strictures; FCSEMS; chronic pancreatitis; endoscopic retrograde cholangiopancreatography; liver transplantation; metal stents