Biodegradable stents in the treatment of benign biliary strictures: Does one size fit all?

2017 ◽  
Vol 29 (6) ◽  
pp. 731-732 ◽  
Author(s):  
Aydin Seref Koksal ◽  
Ahmet T. Eminler ◽  
Erkan Parlak
Keyword(s):  
Biliary Strictures ◽  
Benign Biliary Strictures ◽  
Biodegradable Stents

Percutaneous Management of Benign Biliary Strictures

2021 ◽  
Vol 38 (03) ◽  
pp. 291-299
Author(s):  
Adam Fang ◽  
Il Kyoon Kim ◽  
Ifechi Ukeh ◽  
Vahid Etezadi ◽  
Hyun S. Kim
Keyword(s):  
Treatment Options ◽  
Balloon Dilation ◽  
Percutaneous Transhepatic Cholangiography ◽  
Team Approach ◽  
Biliary Strictures ◽  
Surgical Interventions ◽  
Benign Biliary Strictures ◽  
Elevated Liver Enzymes ◽  
Biodegradable Stents ◽  
Asymptomatic Disease

AbstractBenign biliary strictures are often due to a variety of etiologies, most of which are iatrogenic. Clinical presentation can vary from asymptomatic disease with elevated liver enzymes to obstructive jaundice and recurrent cholangitis. Diagnostic imaging methods, such as ultrasound, multidetector computed tomography, and magnetic resonance imaging (cholangiopancreatography), are used to identify stricture location, extent, and possible source of biliary obstruction. The management of benign biliary strictures requires a multidisciplinary team approach and include endoscopic, percutaneous, and surgical interventions. Percutaneous biliary interventions provide an alternative diagnostic and therapeutic approach, especially in patients who are not amenable to endoscopic evaluation. This review provides an overview of benign biliary strictures and percutaneous management by interventional radiologists. Diagnostic evaluation with percutaneous transhepatic cholangiography and treatment options, including biliary drainage, balloon dilation, retrievable/biodegradable stents, and other innovative minimally invasive options, are discussed.

scholarly journals Percutaneous Transhepatic Biodegradable Biliary Stent Placement for Benign Biliary Strictures

2021 ◽  
Author(s):  
Shaima Abulqasim ◽  
Mohammad Arabi ◽  
Khalid Almasar ◽  
Bayan AlBdah ◽  
Refaat Salman
Keyword(s):  
Stent Placement ◽  
Major Complication ◽  
Biliary Strictures ◽  
Effective Treatment Option ◽  
Duct Occlusion ◽  
Benign Biliary Strictures ◽  
Biodegradable Stents ◽  
Bile Duct Occlusion ◽  
Stricture Recurrence

AbstractThis article aimed to assess the safety and effectiveness of biodegradable stents in the management of benign biliary strictures. This is a retrospective observational study that included all adult patients who had biodegradable stent placement for a benign cause of biliary stricture between July 2016 and August 2019. Nineteen patients were included. Seventeen patients had liver transplant. One patient had hepaticojejunostomy due to primary sclerosing cholangitis and one patient had iatrogenic left main bile duct occlusion. Stents were successfully deployed in all 19 patients (technical success: 100%). Patency rate was 90% (17/19) at 6 months and 80% (12/15) at 12 months. Seven patients in the study had stricture recurrence and needed reintervention with mean time to reintervention of 418 days (range: 8–1,155 days). There was one major complication due to cholangitis and sepsis, which required a treatment course with piperacillin/tazobactam for 10 days. No procedure-related pancreatitis or deaths occurred. Biodegradable stents are a safe and effective treatment option for benign biliary strictures and can achieve long-term patency without the need for reinterventions.

scholarly journals Benign Biliary Strictures: A Systematic Review on Endoscopic Treatment Options

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 221
Author(s):  
May Y.W. Wong ◽  
Payal Saxena ◽  
Arthur J. Kaffes
Keyword(s):  
Endoscopic Treatment ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Treatment Strategies ◽  
Stent Migration ◽  
Metal Stents ◽  
Biliary Cirrhosis ◽  
Biliary Strictures ◽  
Benign Biliary Strictures ◽  
Biodegradable Stents

Benign biliary strictures can be difficult to manage. Untreated biliary strictures can lead to complications, such as chronic cholestasis, jaundice, recurrent sepsis, and secondary biliary cirrhosis, which can have severe ramifications. The management landscape is constantly evolving, with the development of modifiable self-expandable metal stents and biodegradable stents. This review critically appraises current endoscopic treatment strategies, in particular focusing on the shortfalls, such as stent migration and stricture recurrence. It also proposes a treatment algorithm based on aetiologias and the location of the strictures.

scholarly journals Extraluminal recanalization for postoperative biliary obstruction using transseptal needle

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Horinouchi ◽  
Eisuke Ueshima ◽  
Keitaro Sofue ◽  
Shohei Komatsu ◽  
Takuya Okada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Biliary Obstruction ◽  
Hepatic Duct ◽  
Drainage Tube ◽  
Biliary Strictures ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Benign Biliary Strictures ◽  
The Right

Abstract Background Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. The present report describes a successful case of treatment by extraluminal recanalization for postoperative biliary obstruction using a transseptal needle. Case presentation A 66-year-old woman had undergone caudal lobectomy for the treatment of hepatocellular carcinoma. The posterior segmental branch of the bile duct was injured and repaired intraoperatively. Three months after the surgery, the patient had developed biliary leakage from the right hepatic bile duct, resulting in complete biliary obstruction. Since intraluminal recanalization with conventional endoscopic and percutaneous approaches with a guidewire failed, extraluminal recanalization using a transseptal needle with an internal lumen via percutaneous approach was performed under fluoroscopic guidance. The left lateral inferior segmental duct was punctured, and an 8-F transseptal sheath was introduced into the ostium of right hepatic duct. A transseptal needle was advanced, and the right hepatic duct was punctured by targeting an inflated balloon that was placed at the end of the obstructed right hepatic bile duct. After confirming successful puncture using contrast agent injected through the internal lumen of the needle, a 0.014-in. guidewire was advanced into the right hepatic duct. Finally, an 8.5-F internal–external biliary drainage tube was successfully placed without complications. One month after the procedure, the drainage tube was replaced with a 10.2-F drainage tube to dilate the created tract. Subsequent endoscopic internalization was performed 5 months after the procedure. At the 1-year follow-up examination, there was no sign of biliary obstruction and recurrence of hepatocellular carcinoma. Conclusions Recanalization using a transseptal needle can be an alternative technique for rigid biliary obstruction when conventional techniques fail.

scholarly journals A Prospective Multicenter Study of “Inside Stents” for Biliary Stricture: Multicenter Evolving Inside Stent Registry (MEISteR)

2021 ◽  
Vol 10 (13) ◽  
pp. 2936
Author(s):  
Hirofumi Kogure ◽  
Hironari Kato ◽  
Kazumichi Kawakubo ◽  
Hirotoshi Ishiwatari ◽  
Akio Katanuma ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Stent Placement ◽  
Controlled Trial ◽  
Adverse Event Rate ◽  
Success Rates ◽  
Technical Success ◽  
Biliary Strictures ◽  
Prospective Multicenter Study ◽  
Stent Occlusion ◽  
Benign Biliary Strictures

Background: Endoscopic biliary stent placement is the standard of care for biliary strictures, but stents across the papilla are prone to duodenobiliary reflux, which can cause stent occlusion. Preliminary studies of “inside stents” placed above the papilla showed encouraging outcomes, but prospective data with a large cohort were not reported. Methods: This was a prospective multicenter registry of commercially available inside stents for benign and malignant biliary strictures. Primary endpoint was recurrent biliary obstruction (RBO). Secondary endpoints were technical success of stent placement and removal, adverse events, and stricture resolution. Results: A total of 209 inside stents were placed in 132 (51 benign and 81 malignant) cases with biliary strictures in 10 Japanese centers. During the follow-up period of 8.4 months, RBO was observed in 19% of benign strictures. The RBO rate was 49% in malignant strictures, with the median time to RBO of 4.7 months. Technical success rates of stent placement and removal were both 100%. The adverse event rate was 8%. Conclusion: This prospective multicenter study demonstrated that inside stents above the papilla were feasible in malignant and benign biliary strictures, but a randomized controlled trial is warranted to confirm its superiority to conventional stents across the papilla.

Balloon dilatation of benign biliary strictures.

Radiology ◽  
1984 ◽  
Vol 151 (3) ◽  
pp. 613-616 ◽  
Author(s):  
E Salomonowitz ◽  
W R Castaneda-Zuniga ◽  
G Lund ◽  
A H Cragg ◽  
D W Hunter ◽  
...  
Keyword(s):  
Balloon Dilatation ◽  
Biliary Strictures ◽  
Benign Biliary Strictures
Sign in / Sign up

Export Citation Format

Share Document