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Ishizaki Y, Sugimoto M, Takagi T, Suzuki R, Konno N, Asama H, Sato Y, Irie H, Okubo Y, Nakamura J, Takasumi M, Hashimoto M, Kato T, Kobashi R, Hikichi T, Ohira H. Spontaneous disappearance of common bile duct stones following the insertion of a new dumbbell-shaped, covered self-expandable metallic stent in a patient with benign biliary stricture. Clin Case Rep 2021; 9:e04093. [PMID: 34026137 PMCID: PMC8122123 DOI: 10.1002/ccr3.4093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/04/2021] [Accepted: 03/13/2021] [Indexed: 11/11/2022] Open
Abstract
The new dumbbell-shaped, covered self-expanding metallic stent can efficiently remove the choledocholiths in cases with common bile duct (CBD) strictures; moreover, it may potentially prevent a positional displacement and contribute to the better improvement of the CBD stricture.
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Affiliation(s)
- Yuto Ishizaki
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Mitsuru Sugimoto
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Tadayuki Takagi
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Rei Suzuki
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Naoki Konno
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Hiroyuki Asama
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Yuki Sato
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Hiroki Irie
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Yoshinori Okubo
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
- Department of EndoscopyFukushima Medical University HospitalFukushimaJapan
| | - Jun Nakamura
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
- Department of EndoscopyFukushima Medical University HospitalFukushimaJapan
| | - Mika Takasumi
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Minami Hashimoto
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
- Department of EndoscopyFukushima Medical University HospitalFukushimaJapan
| | - Tsunetaka Kato
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
- Department of EndoscopyFukushima Medical University HospitalFukushimaJapan
| | - Ryoichiro Kobashi
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
| | - Takuto Hikichi
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
- Department of EndoscopyFukushima Medical University HospitalFukushimaJapan
| | - Hiromasa Ohira
- Department of Gastroenterology, School of MedicineFukushima Medical UniversityFukushimaJapan
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2
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Ferretti F, Fraquelli M, Cantù P, Penagini R, Casazza G, Vecchi M, Orlando S, Invernizzi F, Branchi F, Donato FM, Elli L. Efficacy and safety of device-assisted enteroscopy ERCP in liver transplantation: A systematic review and meta-analysis. Clin Transplant 2020; 34:e13864. [PMID: 32236978 DOI: 10.1111/ctr.13864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 03/14/2020] [Accepted: 03/22/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Enterobiliary anastomoses are the main source of complications after liver transplantation. An endoscopic approach combining device-assisted enteroscopy and ERCP (DAE-ERCP) is technically feasible in postsurgical anatomy. AIMS This study aimed at assessing the efficacy, feasibility, and safety of DAE-ERCP in liver-transplanted patients (LT) and other subsets (non-LT). METHODS A systematic review and meta-analysis of studies involving DAE procedures in LT patients (between January 2000 and May 2017) was conducted. The main endpoints were as follows: endoscopic, diagnostic, therapeutic, and overall success rates, complications, and the need for surgery. RESULTS A total of 155 studies were retrieved, and 6 relevant trials were analyzed. Overall, 132 subjects (72 LT and 60 non-LT) undergoing 257 DAE-ERCP (135 and 122) were included. Complications were rare (4/257), and no deaths occurred. These are the pooled success rates among LT and non-LT patients: 80%-100% and 82%-95% (enteroscopic), 75%-100% and 89%-100% (diagnostic), 67%-100% and 92%-100% (therapeutic), and 60%-100% and 79%-83% (overall results). The requirement for surgery was similar in the two subgroups. CONCLUSION In managing biliary complications, the high diagnostic and therapeutic success rates of DAE-ERCP combined with its safety and feasibility encourage its application as a first-line approach to transplanted patients.
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Affiliation(s)
- Francesca Ferretti
- Gastroenterology and Endoscopy Division, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Mirella Fraquelli
- Gastroenterology and Endoscopy Division, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Cantù
- Gastroenterology and Endoscopy Division, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Penagini
- Gastroenterology and Endoscopy Division, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Casazza
- Dipartimento di Scienze Biomediche e Cliniche Luigi Sacco, Università degli Studi di Milano, Milan, Italy
| | - Maurizio Vecchi
- Gastroenterology and Endoscopy Division, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Stefania Orlando
- Gastroenterology and Endoscopy Division, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Invernizzi
- Transplant Hepatology Unit, Division of Gastroenterology and Hepatology, A.M. & A. Migliavacca Center for Liver Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Federica Branchi
- Gastroenterology and Endoscopy Division, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Francesca Maria Donato
- Transplant Hepatology Unit, Division of Gastroenterology and Hepatology, A.M. & A. Migliavacca Center for Liver Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Luca Elli
- Gastroenterology and Endoscopy Division, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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4
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Zheng X, Wu J, Sun B, Wu YC, Bo ZY, Wan W, Gao DJ, Hu B. Clinical outcome of endoscopic covered metal stenting for resolution of benign biliary stricture: Systematic review and meta-analysis. Dig Endosc 2017; 29:198-210. [PMID: 27681297 DOI: 10.1111/den.12742] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 09/22/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIM Management of benign biliary stricture is challenging. Endoscopic therapy has evolved as the first-line treatment for various benign biliary strictures. However, covered self-expandable metal stents (CSEMS) have not been approved by the United States Food and Drug Administration for the treatment of benign biliary stricture. With this goal, we conducted the present systemic review and meta-analysis to evaluate the efficacy and safety of endoscopic stenting with CSEMS in the treatment of benign biliary stricture. METHODS Systematic review and meta-analysis by searching PubMed, MEDLINE and Embase databases. RESULTS In total, 37 studies (1677 patients) fulfilled the inclusion criteria. Pooled stricture resolutions were achieved in 83% of cases. Median stent dwelling time was 4.4 months, with median endoscopic retrograde cholangiopancreatography sessions of 2.0. Stricture recurrence at 4-year follow up was 11% (95% CI, 8-14%). Pooled complication rate was 23% (95% CI, 20-26%). CONCLUSIONS Placement of CSEMS is effective in the treatment of benign biliary stricture with relatively short stenting duration and low long-term stricture recurrence rate. However, more prospectively randomized studies are required to confirm the results.
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Affiliation(s)
- Xiao Zheng
- Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Jun Wu
- Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Bo Sun
- Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Ye-Chen Wu
- Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Zhi-Yuan Bo
- Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Wei Wan
- Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Dao-Jian Gao
- Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
| | - Bing Hu
- Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai, China
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