AI Article Synopsis
Article Abstract
Background & Aims: Fully covered self-expanding metal stents (FCSEMS) are gaining acceptance for the treatment of benign biliary strictures. We performed a large prospective multinational study to study the ability to remove these stents after extended indwell and the frequency and durability of stricture resolution.
Methods: In a nonrandomized study at 13 centers in 11 countries, 187 patients with benign biliary strictures received FCSEMS. Removal was scheduled at 10-12 months for patients with chronic pancreatitis or cholecystectomy and at 4-6 months for patients who received liver transplants. The primary outcome measure was removal success, defined as either scheduled endoscopic removal of the stent with no removal-related serious adverse events or spontaneous stent passage without the need for immediate restenting.
Results: Endoscopic removal of FCSEMS was not performed for 10 patients because of death (from unrelated causes), withdrawal of consent, or switch to palliative treatment. For the remaining 177 patients, removal success was accomplished in 74.6% (95% confidence interval [CI], 67.5%-80.8%). Removal success was more frequent in the chronic pancreatitis group (80.5%) than in the liver transplantation (63.4%) or cholecystectomy (61.1%) groups (P = .017). FCSEMS were removed by endoscopy from all patients in whom this procedure was attempted. Stricture resolution without restenting upon FCSEMS removal occurred in 76.3% of patients (95% CI, 69.3%-82.3%). The rate of resolution was lower in patients with FCSEMS migration (odds ratio, 0.22; 95% CI, 0.11-0.46). Over a median follow-up period of 20.3 months (interquartile range, 12.9-24.3 mo), the rate of stricture recurrence was 14.8% (95% CI, 8.2%-20.9%). Stent- or removal-related serious adverse events, most often cholangitis, occurred in 27.3% of patients. There was no stent- or removal-related mortality.
Conclusions: In a large prospective multinational study, removal success of FCSEMS after extended indwell and stricture resolution were achieved for approximately 75% of patients. ClincialTrials.gov number, NCT01014390.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1053/j.gastro.2014.04.043 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predicting apheresis yield and factors affecting peripheral blood stem cell harvesting using a machine learning model.
J Int Med Res
December 2024
Department of Hematology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
Objective: Mobilization and collection of peripheral blood stem cells (PBSCs) are time-intensive and costly. Excessive apheresis sessions can cause physical discomfort for donors and increase the costs associated with collection. Therefore, it is essential to identify key predictive factors for successful harvests to minimize the need for multiple apheresis procedures.
View Article and Find Full Text PDFVertebral Body Tethering in Skeletally Immature Patients: Results of a Prospective U.S. FDA Investigational Device Exemption Study.
J Bone Joint Surg Am
December 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Background: The purpose of this study was to report on 2-year results of vertebral body tethering (VBT), performed under a Food and Drug Administration protocol, to obtain insight into outcomes and complications.
Methods: Forty prospectively enrolled patients with adolescent idiopathic scoliosis (AIS) who had a Sanders score of ≤4 or a Risser score of ≤2 underwent VBT for curves between 40° and 70°. Surgical, radiographic, and patient-reported outcomes were reviewed at a minimum 2-year follow-up.
Procedural and clinical outcomes of Adiana® hysteroscopic tubal occlusion in the Netherlands.
Facts Views Vis Obgyn
December 2024
Background: The Adiana® Permanent Contraception System was a hysteroscopic tubal occlusion device but was withdrawn from the market in 2012.
Objective: To evaluate the safety, feasibility and efficacy of the Adiana hysteroscopic tubal occlusion.
Materials And Methods: A prospective observational multicentre cohort study of 300 women undergoing hysteroscopic sterilisation using the Adiana® was conducted in the Netherlands between 2009 and 2012.
Machine learning based algorithms for virtual early detection and screening of neurodegenerative and neurocognitive disorders: a systematic-review.
Front Neurol
December 2024
Students Research Committee, Ardabil University of Medical Sciences, Ardabil, Iran.
Background And Aim: Neurodegenerative disorders (e.g., Alzheimer's, Parkinson's) lead to neuronal loss; neurocognitive disorders (e.
View Article and Find Full Text PDFBiliary sepsis, characterized by contamination and infection of the biliary tract, poses a serious medical issue with detrimental effects on the patients. While cholecystectomy is the usual treatment for symptomatic gallstones, the most desirable management approach for biliary sepsis remains debated, prompting a scientific evaluation of the long-term effects of cholecystectomy. To compare the long-term outcomes of biliary sepsis in patients undergoing cholecystectomy versus conservative management (CM), this study will systematically review the existing literature to clarify differences in recurrence rates, complication rates, and overall survival.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!