Abstracts submitted to ASGE 2010T1519: Use of Fully Covered Self Expanding Metal Stents (FCSEMS) in the Management of Benign Biliary Diseases (BBD)
Section snippets
Background and Aims
Covered self expanding metal stents (CSEMS) are being used more frequently in benign biliary diseases (BBD). We report the results of a multi-center study with fully covered self expanding metal stent (FCSEMS) placement for the management of BBD.
Methods
Seventy one patients with BBD from six different centers had placement of FCSEMS with flared ends (Wallflex, Boston Scientific, Natick MA) between April 2009 and October 2009. Previous plastic stenting was performed in 43 (60.6%) patients prior to FCSEMS placement. Efficacy of disease resolution after removal of FCSEMS was determined by a combination of symptom resolution, imaging and laboratory studies and choledochoscopy at removal. Post procedural complications were collected retrospectively.
Results
A total of 71 patients (43(60.6%) males) with a mean age of 58.6 ± 13.5 years were analyzed. The most common indication for stent placement was for anastomotic strictures (n=24, 33.8%) followed by gallstone related stricture (n=14, 19.7%), stricture related to chronic pancreatitis (n=11, 15.5%), biliary leaks (n=11, 15.5%), undetermined (n=8, 11.1%) and biliary adenomas (n=3, 4.2%). Of the 71 stents placed, 28 (39.4%) were removed after a mean stent duration of 71.8 ± 42.6 days. Stricture
Conclusion
FCSEMS for BBD is relatively safe and efficacious. Further study of FCSEMS in BBD is warranted to assess long term response in a prospective trial Patients Demographic and Stricture EtiologyEmpty Cell N(%) Mean Age (years) Males (%) Stent Removal (%) Mean Stent Duration (days) Anastomotic Stricture 24(33.8) 55.7 19(79.2) 10/24(41.6) 72.4 Gallstone Related 14(19.7) 60.4 6(42.9) 7/14(50.0) 87 Pancreatitis related 11(15.5) 59.5 8(72.7) 4/11(36.3) 93.25 Biliary Leak 11(15.5) 51.8 6(54.5) 3/11(27.3) 44 Undetermined 8(12.3) 53.5 4(50) 3/8(37.5)