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Endoscopic therapy using a self-expandable metallic stent with an anti-migration system for postorthotopic liver transplantation anastomotic biliary stricture

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World Journal of Gastrointestinal Endoscopy 2022年第9期14卷 547-554页

作者： larissa Wermelinger Pinheiro Fernanda Prata martins Gustavo Andrade De Paulo mðnica lúcia campos contini Angelo Paulo Ferrari Ermelindo Della libera Department of Gastroenterology Federal University of São Paulo/Escola Paulista de MedicinaSão Paulo 04023-900Brazil Department of Endoscopy Unit Hosp Israelita Albert EinsteinSão Paulo 04042033Brazil

BACKGROUND Endoscopic therapy using multiple plastic stents(mPSs)is the standard therapy for postorthotopic liver transplantation(p-OlT)anastomotic biliary stricture(ABS).However,this approach demands repeated *** studies us-ing fully covered self-expandable metallic stents(FCSEmS)have shown en-couraging results,but migration occurs in 10%to 40%of *** objective of this retrospective study was to evaluate the efficacy of endoscopic treatment using FCSEmS with an anti-migration system(Am-FCSEmS)in patients with p-OlT *** To evaluate the efficacy of endoscopic treatment using an Am-FCSEmS in patients with p-OlT *** This study was conducted in a private tertiary care centre in S?o Paulo,Brazil and was approved by our institution's Human Research *** April 2018 to October 2020,regardless of previous endoscopic treatment(mPS or FCSEmS),17 patients with p-OlT ABS and indications for endoscopic therapy were included in this *** exclusion criteria were pregnancy,nonanastomotic biliary or hilar stricture,hepatic artery stenosis/thrombosis,isolated biliary fistulae,a distance shorter than 2 cm from the stricture to the hepatic hilum,and patient *** primary endpoint was the efficacy of p-OlT ABS endoscopic treatment using an Am-FCSEmS that re-mained in place for a 12-mo *** sphincterotomy was performed in patients with native papilla,and an Am-FCSEmS(10 mm in final diameter and 60 or 80 mm in length)was placed(Hanarostent Tm mI Tech,Co).Balloon stricture dilation was performed only if necessary to introduce the *** Three patients were excluded due to loss to follow-up before stent *** the 14 patients included and followed,7 were women,and the average age was 56 years(range:28-76).The average period of Am-FCSEmS placement was 362±109 *** success occurred in all 14 patients(100%).There were no cases of distal stent *** resolution of the stricture occurred in 13/14 patien

关键词： liver transplantation Endoscopy Endoscopic retrograde cholangiopancreatography Biliary strictures Self-expandable metallic biliary stents

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