Fully Covered Self-expandable Metal Stents (FCMS) in Benign Biliary Strictures

Temporary Placement of Fully Covered Self-expandable Metal Stents in Benign Biliary Strictures

Endoscopic treatment of benign biliary strictures can be challenging. Balloon dilation and/or plastic stent placement are currently the most popular techniques. Partially covered self-expandable metallic stents have also shown to be effective but can be difficult to remove. A novel fully covered metallic stent has recently been developed.

The aim of this study was to prospectively evaluate the placement of fully covered self-expandable metallic stents (FCSEMS) in this setting.

After inclusion, an endoscopic procedure (ERCP) was performed in all patients in order to place a FCMS across the benign biliary stricture. The FCMS was left in place for 6 months and then extracted during a second ERCP procedure. An opacification was performed to assess the efficacy of stenting. Patients were followed up during one year after FCMS extraction.

Inclusion Criteria:

• a history of liver transplantation, chronic pancreatitis or biliary surgery
• impairment of liver function tests such as elevated liver enzymes and/or cholestasis
• a biliary stricture associated with ductal dilation detected by US, CT or MRI, with a minimum distance of 2cm between the upper stricture's edge and the lower limit of the main biliary confluence or liver hilum .

Exclusion Criteria:

• an uncertainty about the benign nature of the stricture
• an intra-hepatic cholangitis and/ or a stricture extending beyond the hilum