Fully covered metallic stents for anastomotic biliary strictures after living donor liver transplantation

Naohiro Komatsu; Eisuke Ozawa; Masanori Fukushima; Hironori Sawase; Kazuyoshi Nagata; Satoshi Miuma; Hisamitsu Miyaaki; Akihiko Soyama; Masaaki Hidaka; Susumu Eguchi; Kazuhiko Nakao

doi:10.1002/deo2.225

Fully covered metallic stents for anastomotic biliary strictures after living donor liver transplantation

DEN Open. 2023 Mar 27;3(1):e225. doi: 10.1002/deo2.225. eCollection 2023 Apr.

Affiliations

¹ Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan.
² Department of Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan.

Abstract

Objectives: Anastomotic biliary strictures (ABSs) are common complications following living donor liver transplantation (LDLT). We evaluated the feasibility of a novel removable, intraductal, fully covered, self-expandable metallic stent (FCSEMS) for the treatment of ABSs following LDLT.

Methods: Nine patients with duct-to-duct ABSs that developed following LDLT were prospectively enrolled in this study. We placed a short FCSEMS with a long lasso and middle waist formation in each patient's ABS above the papilla and removed it 16 weeks later.

Results: The FCSEMS placements were successful in all nine cases. Four patients experienced mild cholangitis, which was resolved with conservative treatment. Additionally, there was one case of distal migration. The FCSEMSs were successfully removed from all the patients, and the clinical success rate was 100%. Stricture recurrence occurred in one (11.1%) patient during the follow-up period.

Limitations: The small number and lack of comparison with other types of FCSEMSs and plastic stents.

Conclusions: Intraductal placement of FCSEMSs is useful for treating refractory ABSs after LDLT, although further studies are required with larger sample sizes.

Keywords: anastomotic biliary stricture; cholangitis; fully covered self‐expandable metallic stent; living donor liver transplantation; plastic stent.