Clinical outcome of endoscopic covered metal stenting for resolution of benign biliary stricture: Systematic review and meta-analysis.
OBJECTIVE
Management of benign biliary stricture is challenging. Endoscopic therapy has evolved as the first-line treatment for various benign biliary strictures. However, covered self-expandable metal stents (CSEMS) have not been approved by the United States Food and Drug Administration for the treatment of benign biliary stricture. With this goal, we conducted the present systemic review and meta-analysis to evaluate the efficacy and safety of endoscopic stenting with CSEMS in the treatment of benign biliary stricture.


METHODS
Systematic review and meta-analysis by searching PubMed, MEDLINE and Embase databases.


RESULTS
In total, 37 studies (1677 patients) fulfilled the inclusion criteria. Pooled stricture resolutions were achieved in 83% of cases. Median stent dwelling time was 4.4 months, with median endoscopic retrograde cholangiopancreatography sessions of 2.0. Stricture recurrence at 4-year follow up was 11% (95% CI, 8-14%). Pooled complication rate was 23% (95% CI, 20-26%).


CONCLUSIONS
Placement of CSEMS is effective in the treatment of benign biliary stricture with relatively short stenting duration and low long-term stricture recurrence rate. However, more prospectively randomized studies are required to confirm the results.
Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China.
Xiao
X
Zheng
Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China.
Jun
J
Wu
Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China.
Bo
B
Sun
Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China.
Ye-Chen
YC
Wu
Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China.
Zhi-Yuan
ZY
Bo
Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China.
Wei
W
Wan
Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China.
Dao-Jian
DJ
Gao
Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China.
Bing
B
Hu
D002779:Cholestasis / Q000209:etiology* / Q000601:surgery*; D003251:Constriction, Pathologic; D004724:Endoscopy; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069322:Self Expandable Metallic Stents; D016896:Treatment Outcome
benign biliary stricture; covered self-expandable metal stent; endoscopic retrograde cholangiopancreatography; meta-analysis; stent