Intraductal placement of non-flared fully covered metallic stent for refractory anastomotic biliary strictures after living donor liver transplantation: Long-term results of prospective multicenter trial
- Authors
- Yoo, Jeong-Ju; Lee, Jong-Kyun; Moon, Jong Ho; Lee, Yun Nah; Park, Jae Keun; Lee, Kyu Taek; Lee, Kwang Hyuck; Lee, Woo Jin; Woo, Sang Myung; Lee, Tae Hoon; Park, Sang-Heum
- Issue Date
- Mar-2020
- Publisher
- Blackwell Publishing Inc.
- Keywords
- bile duct stricture; fully covered self-expandable metallic stent; living donor liver transplantation
- Citation
- Journal of Gastroenterology and Hepatology, v.35, no.3, pp 492 - 498
- Pages
- 7
- Journal Title
- Journal of Gastroenterology and Hepatology
- Volume
- 35
- Number
- 3
- Start Page
- 492
- End Page
- 498
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/3076
- DOI
- 10.1111/jgh.14831
- ISSN
- 0815-9319
1440-1746
- Abstract
- Background and Aim Fully covered self-expandable metallic stent (FCSEMS) may be an effective modality for managing anastomotic biliary stricture (ABS) after liver transplantation. However, stent migration and stent-induced ductal injury are the main limitations. The objective of this study was to evaluate the usefulness of an unflared, intraductal FCSEMS that was designed to minimize migration and ductal injury for refractory ABS after living donor liver transplantation (LDLT). Methods A total of 32 consecutive patients with symptomatic ABS after LDLT unresolved by plastic stents with or without balloon dilation at four tertiary medical centers were prospectively enrolled. A short (3 or 5 cm) FCSEMS having long lasso (10 cm) used in this study had unflared convex ends to minimize tissue hyperplasia and smaller center portion to prevent migration. The FCSEMS was placed above the papilla and removed at 3-4 months after stenting. Results Technical and clinical success rates of intraductal placement with FCSEMS were 100% (32/32) and 81.2% (26/32), respectively. Early stent migration was observed in five (15.6%) patients. However, three patients with early stent migration had stricture resolution without needing additional intervention. Intended stent removal was successful in 27 (100%) patients (median, 101 days; range, 23-118 days). No stent-induced ductal change was observed in all patients. Stricture recurrence was observed in 11.5% (3/26) of patients during 639 days of median duration of follow-up (range, 366-2079 days). Conclusions Intraductal placement of an unflared short FCSEMS may be a promising option for refractory ABS after LDLT with minimal stent-induced ductal injury and stent migration.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.