Role of fully covered self-expandable metal stent for treatment of benign biliary strictures and bile leaks
© 2012, Korean Radiological Society. All rights reserved. Endoscopic therapy by balloon dilation and placement of multiple large-bore plastic stents is the treatment of choice for benign biliary stricture. This approach is effective but it typically requires multiple endoscopic sessions given the sh...
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th-mahidol.150852018-06-11T12:19:33Z Role of fully covered self-expandable metal stent for treatment of benign biliary strictures and bile leaks Nonthalee Pausawasadi Tanassanee Soontornmanokul Rungsun Rerknimitr Mahidol University Chulalongkorn University Medicine © 2012, Korean Radiological Society. All rights reserved. Endoscopic therapy by balloon dilation and placement of multiple large-bore plastic stents is the treatment of choice for benign biliary stricture. This approach is effective but it typically requires multiple endoscopic sessions given the short duration of stent patency. The endoscopic approach for treatment of bile leak involves the placement of a stent with or without biliary sphincterotomy. The self-expandable metal stent (SEMS) has traditionally been used for palliation of malignant biliary strictures given the long duration of stent patency owing to their larger stent diameter. Recently, SEMS has been used in a variety of benign biliary strictures and leaks, especially with the design of the covered self-expandable metal stent (CSEMS), which permits endoscopic-mediated stent removal. The use of CSEMS in benign biliary stricture could potentially result in a decrease in endoscopic sessions and it is technically easier when compared to placement of multiple plastic stents. However, complications such as cholecystitis due to blockage of cystic duct, stent migration, infection and pancreatitis have been reported. The potential subsegmental occlusion of contralateral intrahepatic ducts also limits the use of CSEMS in hilar stricture. Certain techniques and improvement of stent design may overcome these challenges in the future. Thus, CSEMS may be appropriate in only highly selected conditions, such as refractory benign biliary stricture, despite multiple plastic stent placement or difficult to treat bile duct stricture from chronic pancreatitis, and should not be used routinely. This review focuses on the use of fully covered self-expandable metal stent for benign biliary strictures and bile leaks. 2018-06-11T05:19:33Z 2018-06-11T05:19:33Z 2012-01-01 Review Korean Journal of Radiology. Vol.13, (2012), S67-S73 10.3348/kjr.2012.13.S1.S67 12296929 2-s2.0-84866437987 https://repository.li.mahidol.ac.th/handle/123456789/15085 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84866437987&origin=inward |
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© 2012, Korean Radiological Society. All rights reserved. Endoscopic therapy by balloon dilation and placement of multiple large-bore plastic stents is the treatment of choice for benign biliary stricture. This approach is effective but it typically requires multiple endoscopic sessions given the short duration of stent patency. The endoscopic approach for treatment of bile leak involves the placement of a stent with or without biliary sphincterotomy. The self-expandable metal stent (SEMS) has traditionally been used for palliation of malignant biliary strictures given the long duration of stent patency owing to their larger stent diameter. Recently, SEMS has been used in a variety of benign biliary strictures and leaks, especially with the design of the covered self-expandable metal stent (CSEMS), which permits endoscopic-mediated stent removal. The use of CSEMS in benign biliary stricture could potentially result in a decrease in endoscopic sessions and it is technically easier when compared to placement of multiple plastic stents. However, complications such as cholecystitis due to blockage of cystic duct, stent migration, infection and pancreatitis have been reported. The potential subsegmental occlusion of contralateral intrahepatic ducts also limits the use of CSEMS in hilar stricture. Certain techniques and improvement of stent design may overcome these challenges in the future. Thus, CSEMS may be appropriate in only highly selected conditions, such as refractory benign biliary stricture, despite multiple plastic stent placement or difficult to treat bile duct stricture from chronic pancreatitis, and should not be used routinely. This review focuses on the use of fully covered self-expandable metal stent for benign biliary strictures and bile leaks. |
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Mahidol University |
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Mahidol University Nonthalee Pausawasadi Tanassanee Soontornmanokul Rungsun Rerknimitr |
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Review |
author |
Nonthalee Pausawasadi Tanassanee Soontornmanokul Rungsun Rerknimitr |
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Nonthalee Pausawasadi |
title |
Role of fully covered self-expandable metal stent for treatment of benign biliary strictures and bile leaks |
title_short |
Role of fully covered self-expandable metal stent for treatment of benign biliary strictures and bile leaks |
title_full |
Role of fully covered self-expandable metal stent for treatment of benign biliary strictures and bile leaks |
title_fullStr |
Role of fully covered self-expandable metal stent for treatment of benign biliary strictures and bile leaks |
title_full_unstemmed |
Role of fully covered self-expandable metal stent for treatment of benign biliary strictures and bile leaks |
title_sort |
role of fully covered self-expandable metal stent for treatment of benign biliary strictures and bile leaks |
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2018 |
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https://repository.li.mahidol.ac.th/handle/123456789/15085 |
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1763491876244029440 |