Brief Article
Copyright ©2012 Baishideng. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2012; 4(9): 405-408
Published online Sep 16, 2012. doi: 10.4253/wjge.v4.i9.405
Fully covered self-expandable metal stents for treatment of malignant and benign biliary strictures
Ahmed Abdel Samie, Stephan Dette, Ulrich Vöhringer, Michael Stumpf, Karolin Kopischke, Lorenz Theilmann
Ahmed Abdel Samie, Stephan Dette, Ulrich Vöhringer, Karolin Kopischke, Lorenz Theilmann, Department of Gastroenterology, Pforzheim Hospital, Kanzlerstr. 2-6, 75175 Pforzheim, Germany
Michael Stumpf, Department of Surgery, Pforzheim Hospital, Kanzlerstr. 2-6, 75175 Pforzheim, Germany
Author contributions: Abdel Samie A contributed to conception and design, acquisition of data; Dette S and Vöhringer U direct participated in the study, acquisition of data; Stumpf M made acquisition of surgical data and revising surgical contents of the manuscript; Kopischke K made acquisition of data; Theilmann L direct participated in the study, revising the article critically.
Correspondence to: Ahmed Abdel Samie, MD, FEBGH, FEFIM, Department of Gastroenterology, Pforzheim Hospital, Kanzler-Str. 2-6, 75175 Pforzheim, Germany. abdelsamie@ngi.de
Telephone: +49-7231-9693656 Fax: +49-7231-9692682
Received: February 8, 2012
Revised: June 4, 2012
Accepted: September 12, 2012
Published online: September 16, 2012
Abstract

AIM: To present a series of covered self-expandable metal stents (CSEMS) placed for different indications and to evaluate the effectiveness, complications and extractability of these devices.

METHODS: We therefore retrospectively reviewed the courses of patients who received CSEMS due to malignant as well as benign biliary strictures and post-sphincterotomy bleeding in our endoscopic unit between January 2010 and October 2011.

RESULTS: Twenty-six patients received 28 stents due to different indications (20 stents due to malignant biliary strictures, six stents due to benign biliary strictures and two stents due to post-sphincterotomy bleeding). Biliary obstruction was relieved in all cases, regardless of the underlying cause. Hemostasis could be achieved in the two patients who received the stents for this purpose. Complications occurred in five patients (18%). Two patients (7%) developed cholecystitis, stents dislocated/migrated in other two patients (7%), and in one patient (3.6%) stent occlusion was documented during the study period. Seven stents were extracted endoscopically. Removal of stents was easily possible in all cases in which it was desired using standard forceps. Twelve patients underwent surgery with pylorus preserving duodenopancreatectomy. In all patients stents could be removed during the operation without difficulties.

CONCLUSION: Despite the higher costs of these devices, fully covered self-expanding metal stents may be suitable to relief biliary obstruction due to bile duct stenosis, regardless of the underlying cause. CSEMS may also represent an effective treatment strategy of severe post-sphincterotomy bleeding, not controlled by other measures.

Keywords: Completely covered self-expandable metal stents; Pancreatic carcinoma; Biliary stenosis