Efficacy And Safety Of Fully-covered Self-expandable Metallic Stents In The Treatment Of Distal Biliary Strictures

Objective To investigate the efficacy and safety of fully-covered self-covered self-expandable metallic stents(FCSEMS) in endoscopic retrograde cholangiopancreatography(ERCP) procedures for distal biliary strictures.Methods This is a prospective study of patients with distal biliary strictures, who underwent FCSEMS implantation for treatment via ERCP from October 2014 to December 2015. The stents of different types, lengths and diameters were chosen according to the conditions of the patients. Other endoscopic procedures, such as stone extraction and pancreatic stent implantation were carried out simultaneously if necessary. Thereafter, the patients were required to attend the outpatient for regular review. The therapeutic effects and the associated early and long-term complications were observed at the end point.Results FCSEMS deployment in 47 patients with distal biliary strictures successfully,the technical successful rate is 100%. Stent failure in 3 patients, the effective rate is 93.6%. 44 patients who placed the FCSEMS successfully and effectively were followed up. There were 39 patients with malignant biliary strictures and 5 patients with benign biliary strictures. For the malignant biliary strictures, stent patency in 90 day, 180 day, 360 day is 84%, 59%, 24%, respectively. For the benign strictures, after 232 day(49-459)median follow-up, the stent effective rate is 83.3%. The early complications included mortality in 30 days(1 time), post-ERCP pancreatitis(15 times), hyper amylasemia(4 times), acute cholangitis( 3 times), acute renal failure( 2 times). The long-term complications included stent migration(1 times), stent occlusion(3 times).Conclusions FCSEMS have long patency to any biliary strictures, serving as an effective treatment of distal biliary strictures. But more attention should be paid to the complication events.