Self-expanding metallic stents in benign postoperative biliary strictures: a difficult surgical obstacle?
(2007) Hepato-Gastroenterology : current medical and surgical trends — Vol. 54, n° 76, p. 999-1003 (2007)
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- BACKGROUND/AIMS: To report the hazards of surgical management in patients suffering from benign postoperative biliary strictures (BBS) previously treated with self-expanding metallic stents (SEMS). METHODOLOGY: Five patients with BBS were treated by SEMS (Wallstent in 3 patients and Gianturco stent in 2) through an endoscopic (2 patients) or a percutaneous transhepatic route (3 patients). Metallic stent obstruction due to intraprosthetic epithelial hyperplasia was observed in all patients, being responsible for severe cholangitis and intrahepatic stones in 3 and 2 patients respectively. RESULTS: One patient remains free of symptoms but presented with right posterior liver atrophy. Difficult biliary repair was encountered in 3 patients, requiring excision and reconstruction of the main biliary convergence for severely damaged biliary wall and epithelium by metallic stents. One patient with a SEMS extended upward the right secondary biliary divisions required a right hemihepatectomy. CONCLUSIONS: The surgical management of benign biliary strictures is severely complicated by the presence of metallic stents. Thus, SEMS should not be employed for treating BBS in healthy patients with a low operative risk.
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Stainier, L., Hubert, C., Jouret, M., Deprez, P., Goffette, P., & Gigot, J.-F. (2007). Self-expanding metallic stents in benign postoperative biliary strictures: a difficult surgical obstacle? Hepato-Gastroenterology : current medical and surgical trends, 54(76), 999-1003. https://hdl.handle.net/2078.5/209499 (Original work published 2007)