A non-randomized study in consecutive patients with postcholecystectomy refractory biliary leaks who were managed endoscopically with the use of multiple plastic stents or fully covered self-expandable metal stents (with videos)

Gastrointestinal Endoscopy
Jorge CanenaPedro Mota Veiga

Abstract

Endoscopic management of postcholecystectomy biliary leaks is widely accepted as the treatment of choice. However, refractory biliary leaks after a combination of biliary sphincterotomy and the placement of a large-bore (10F) plastic stent can occur, and the optimal rescue endotherapy for this situation is unclear. To compare the clinical effectiveness of the use of a fully covered self-expandable metal stent (FCSEMS) with the placement of multiple plastic stents (MPS) for the treatment of postcholecystectomy refractory biliary leaks. Prospective study. Two tertiary-care referral academic centers and one general district hospital. Forty consecutive patients with refractory biliary leaks who underwent endoscopic management. Temporary placement of MPS (n = 20) or FCSEMSs (n = 20). Clinical outcomes of endotherapy as well as the technical success, adverse events, need for reinterventions, and prognostic factors for clinical success. Endotherapy was possible in all patients. After endotherapy, closure of the leak was accomplished in 13 patients (65%) who received MPS and in 20 patients (100%) who received FCSEMSs (P = .004). The Kaplan-Meier (log-rank) leak-free survival analysis showed a statistically significant difference betwee...Continue Reading

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Citations

Jun 2, 2018·Minerva gastroenterologica e dietologica·Benedetto MangiavillanoAlessandro Repici
Jun 3, 2020·The American Journal of Gastroenterology·Dina S Ahmad, Ashley Faulx
Dec 4, 2020·Endoscopy International Open·Patrick YachimskiAnthony Gamboa
Jun 12, 2021·World Journal of Emergency Surgery : WJES·Nicola de'AngelisDaniele Sommacale
Aug 19, 2021·Scientific Reports·Jorge CanenaMário Dinis-Ribeiro
Aug 14, 2021·GE Portuguese Journal of Gastroenterology·Ricardo Rio-Tinto, Jorge Canena

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