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United European Gastroenterol J. 2016 Jun;4(3):403-12. doi: 10.1177/2050640615606550. Epub 2015 Sep 24.

Temporary placement of fully covered self-expandable metal stents for the treatment of benign biliary strictures.

United European gastroenterology journal

Ulriikka Chaput, Ariane Vienne, Etienne Audureau, Paul Bauret, Philippe Bichard, Dimitri Coumaros, Bertrand Napoléon, Thierry Ponchon, Jean-Christophe Duchmann, René Laugier, Hervé Lamouliatte, Bruno Védrenne, Marianne Gaudric, Stanislas Chaussade, Françoise Robin, Sarah Leblanc, Frédéric Prat


  1. Gastroenterology Department, Cochin Hospital, Paris, France.
  2. Public Health Department, Henri Mondor Hospital, LIC EA4393 Paris Est Créteil University (UPEC), Paris, France.
  3. Gastroenterology Department, Saint Eloi Hospital, Montpellier, France.
  4. Gastroenterology Department, La Tronche Hospital, Grenoble, France.
  5. Gastroenterology Department, Civil Hospital of Strasbourg, Strasbourg, France.
  6. Gastroenterology Department, Private Hospital Jean Mermoz, Lyon, France.
  7. Gastroenterology Department, Edouard Herriot Hospital, Lyon, France.
  8. Gastroenterology Department, Hospital of Compiègne, Compiègne, France.
  9. Gastroenterology Department, La Timone Hospital, Marseille, France.
  10. Gastroenterology Department, Saint-André Hospital, Bordeaux, France.
  11. Gastroenterology Department, Emile Muller Hospital, Mulhouse, France.
  12. Gastroenterology Department, Cochin Hospital, Paris, France; Paris-Descartes University, Paris, France.
  13. French Society of Digestive Endoscopy, Lyon and Paris, France.

PMID: 27403307 PMCID: PMC4924429 DOI: 10.1177/2050640615606550


BACKGROUND: Endoscopic treatment of benign biliary strictures (BBS) can be challenging.

OBJECTIVE: To evaluate the efficacy of fully covered self-expandable metal stents (FCSEMS) in BBS.

METHODS: Ninety-two consecutive patients with BBS (chronic pancreatitis (n = 42), anastomotic after liver transplantation (n = 36), and post biliary surgical procedure (n = 14)) were included. FCSEMS were placed across strictures for 6 months before endoscopic extraction. Early success rate was defined as the absence of biliary stricture or as a minimal residual anomaly on post-stent removal endoscopic retrograde cholangiopancreatography (ERCP). Secondary outcomes were the final success and stricture recurrence rates as well as procedure-related morbidity.

RESULTS: Stenting was successful in all patients. Stenting associated complications were minor and occurred in 22 (23.9%) patients. Migration occurred in 23 (25%) patients. Stent extraction was successful in all but two patients with proximal stent migration. ERCP after the 6 months stenting showed an early success in 84.9% patients (chronic pancreatitis patients: 94.7%, liver transplant: 87.9%, post-surgical: 61.5%) (p = 0.01). Final success was observed in 57/73 (78.1%) patients with a median follow-up of 12 ± 3.56 months. Recurrence of biliary stricture occurred in 16/73 (21.9%) patients.

CONCLUSIONS: FCSEMS placement is efficient for patients with BBS, in particular for chronic pancreatitis patients. Stent extraction after 6 months indwelling, although generally feasible, may fail in a few cases.

Keywords: Benign biliary strictures; FCSEMS; chronic pancreatitis; endoscopic retrograde cholangiopancreatography; liver transplantation; metal stents


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