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Gastrointest Endosc. 2018 Apr;87(4):1132-1137. doi: 10.1016/j.gie.2017.10.042. Epub 2017 Nov 8.

A pilot study of endoscopically inserted biodegradable biliary stents in the treatment of benign biliary strictures and cystic duct leaks.

Author information

1
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
2
Department of Clinical Radiology, Tampere University Hospital, Tampere, Finland.
3
Hospital District Administration, Päijät-Häme Central Hospital, Lahti, Finland; Medical School, University of Tampere, Tampere, Finland.
4
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland; Medical School, University of Tampere, Tampere, Finland.

Abstract

BACKGROUND AND AIMS:

Self-expanding biodegradable biliary stents (BDBSs) have recently become available for use in endoscopic retrograde cholangiography (ERC). The aim was to evaluate the effectiveness and safety of novel BDBSs in iatrogenic cystic duct leaks and benign biliary strictures (BBSs).

METHODS:

Patients providing informed consent were recruited for the prospective study. Braided self-expanding poly-dioxanone BDBSs were inserted using ERC during from 2014 to 2016. Repeated liver function tests and magnetic resonance imaging were performed during follow-up. The main outcomes were treatment success and adverse events.

RESULTS:

Thirteen patients, 5 women, median age 67 years (range, 43-79) underwent BDBS insertion for iatrogenic cystic duct leak (n = 7) or BBS (n = 6). Stent insertion using ERC was successful in all cases. All bile leaks were treated uneventfully with BDBSs. In BBSs, the clinical success rate of BDBS therapy was 83% in a median of 21 months of follow-up (range, 14-25). Early ERC-related adverse events included 1 cholangitis (8%) and 1 pancreatitis (8%), both in the stricture group. During the first 90 days, 23% of patients were readmitted for mild cholangitis.

CONCLUSIONS:

The short- and long-term safety of endoscopically inserted poly-dioxanone BDBSs was satisfactory. The management of cystic duct leaks and benign distal common bile duct strictures was highly successful. Episodes of mild cholangitis during stent indwelling seemed to be typical of BDBSs. The advantage of BDBSs is the avoidance of repeated endoscopy for stent removal. (Clinical trial registration number: NCT02353286.).

PMID:
29128386
DOI:
10.1016/j.gie.2017.10.042

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