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• W1982482462 abstract "Limited data is available regarding fully covered metal stents in the management of malignant distal biliary strictures since its availability. The aim of this study was to evaluate the safety of a fully covered self-expanding metal stent (FCSEMS) in treating malignant biliary strictures at multiple institutions. We report our long term retrospective analysis from six centers. Between June 2007 and November 2010, 260 patients (142 males, median age 68 years) underwent ERCP with placement of FCSEMS (WallFlex, Boston Scientific, Natick, MA) for the palliation of obstructive jaundice in the setting of pancreatic adenocarcinoma (169), metastatic disease (36), cholangiocarcinoma (23), ampullary cancer (19), or other (13). Patients were evaluated clinically in follow-up and biochemical tests of liver function were obtained. Data was recorded for the following variables: patient survival, duration of stent patency, the need for subsequent biliary intervention and complications. A total of 266 fully covered WallFlex stents were placed in 260 patients. There was a median survival of 100 days (range 7-531 days). There was a mean follow-up of 128 ± 118 days (range 2-519 days). Biliary decompression was successful in 252 patients (97%). At the end of the study period, 121 were alive with a patent stent, 70 patients died with a patent stent, 40 patients were successfully bridged to surgery, 8 patients had their patent stent removed and no need for further stenting, 18 patients were lost to follow-up. Eight patients who had a successfully placed FCSEMS were considered a failure due to the following reason: migration (2), cholecystitis necessitating cholecystostomy placement (1), cholangitis (1), stent occlusion (1) intolerable pain (1), cystic duct obstruction (1), and removal for management of proximal biliary obstruction (1). Two additional patients experienced migration that did not require FCSEMS removal or replacement. Stent replacement was required in 10 patients, of whom 6 had a second Wallflex placed. The remaining 4 were in the failure group and underwent replacement with either uncovered stents or plastic stents. Other complications, managed conservatively, included pain (2), post-ERCP pancreatitis (4), fever (1), retroperitoneal perforation (1) and post-sphincterotomy bleeding (1). The mean patency duration was 328 days (SE 19.04). The patency percentage was 83% at 3 months, 63% at 6 months and 48.5% at 12 months. In the management of malignant distal biliary strictures, the fully covered Wallflex stent has acceptable patency and complication rates and achieves adequate biliary decompression in the majority of patients. Further long term prospective data are required to confirm this observation." @default.
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• W1982482462 date "2011-04-01" @default.
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• W1982482462 title "Mo1459 Evaluation of a Fully Covered Self-Expanding Metal Stent in Malignant Biliary Obstruction: Follow-Up of a Multi-Center Study" @default.
• W1982482462 doi "https://doi.org/10.1016/j.gie.2011.03.757" @default.
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