Multiple plastic stents versus covered metal stent for treatment of anastomotic biliary strictures after liver transplantation : a prospective, randomized, multicenter trial

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dc.contributor University of Helsinki, Department of Surgery en
dc.contributor University of Helsinki, Clinicum en
dc.contributor.author Tal, Andrea Oliver
dc.contributor.author Finkelmeier, Fabian
dc.contributor.author Filmann, Natalie
dc.contributor.author Kylänpää, Leena
dc.contributor.author Udd, Marianne
dc.contributor.author Parzanese, Ilaria
dc.contributor.author Cantu, Paolo
dc.contributor.author Dechene, Alexander
dc.contributor.author Penndorf, Volker
dc.contributor.author Schnitzbauer, Andreas
dc.contributor.author Friedrich-Rust, Mireen
dc.contributor.author Zeuzem, Stefan
dc.contributor.author Albert, Joerg G.
dc.date.accessioned 2019-01-23T22:39:08Z
dc.date.available 2021-10-01T02:45:43Z
dc.date.issued 2017-12
dc.identifier.citation Tal , A O , Finkelmeier , F , Filmann , N , Kylänpää , L , Udd , M , Parzanese , I , Cantu , P , Dechene , A , Penndorf , V , Schnitzbauer , A , Friedrich-Rust , M , Zeuzem , S & Albert , J G 2017 , ' Multiple plastic stents versus covered metal stent for treatment of anastomotic biliary strictures after liver transplantation : a prospective, randomized, multicenter trial ' , Gastrointestinal Endoscopy , vol. 86 , no. 6 , pp. 1038-1045 . https://doi.org/10.1016/j.gie.2017.03.009 en
dc.identifier.issn 0016-5107
dc.identifier.other PURE: 94484976
dc.identifier.other PURE UUID: 68621f17-0e4f-4450-99f9-eb547752632b
dc.identifier.other WOS: 000415159500014
dc.identifier.other Scopus: 85018190413
dc.identifier.uri http://hdl.handle.net/10138/298131
dc.description.abstract Background and Aims: Treatment of anastomotic biliary strictures (ABSs) after orthotopic liver transplantation by endoscopic insertion of multiple plastic stents (MPSs) is well established. The use of covered self-expandable metal stents (cSEMSs) for this indication is less investigated. Methods: In an open-label, multicenter, randomized trial, patients with confirmed ABSs were randomly assigned 1:1 to receive either an MPS or a cSEMS. The primary endpoint was the number of endoscopic interventions until ABS resolution. Secondary endpoints were frequency of adverse events, treatment success rates, and time to treatment success and recurrence of ABS during follow-up of at least 1 year. Results: Fifty-eight patients were included between 2012 and 2015, and 48 patients completed follow-up. Patients receiving MPS (n = 24) underwent a median of 4 (range, 3-12) endoscopic retrograde cholangiography examinations, whereas those in the cSEMS group (n = 24) underwent a median of 2 (range, 2-12) sessions until ABS resolution (P <.001). A median of 8 (range, 2-32) stents was used until ABS resolution within the MPS group and 1 (range, 1-24) in the cSEMS group (P <.0001). cSEMS migration occurred in 8 (33.3%) patients. Treatment duration did not differ significantly. Initial treatment success rates were high with 23 (95.8%) in the MPS group and 24 (100%) for cSEMSs (P = 1). Five (20.8%) patients in both groups showed stricture recurrence after a median follow-up of 500 days (range, 48-1317 days). Conclusions: cSEMSs for treatment of ABSs needed less endoscopic interventions to achieve similar efficacy as MPS and might become a new treatment standard. However, the optimal duration of cSEMS therapy and cost-efficacy have to be evaluated. en
dc.format.extent 8
dc.language.iso eng
dc.relation.ispartof Gastrointestinal Endoscopy
dc.rights en
dc.subject ENDOSCOPIC TREATMENT en
dc.subject MANAGEMENT en
dc.subject THERAPY en
dc.subject OUTCOMES en
dc.subject COMPLICATIONS en
dc.subject STENOSIS en
dc.subject DISEASE en
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology en
dc.title Multiple plastic stents versus covered metal stent for treatment of anastomotic biliary strictures after liver transplantation : a prospective, randomized, multicenter trial en
dc.type Article
dc.description.version Peer reviewed
dc.identifier.doi https://doi.org/10.1016/j.gie.2017.03.009
dc.type.uri info:eu-repo/semantics/other
dc.type.uri info:eu-repo/semantics/publishedVersion
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