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Efficacy and safety of fully covered self-expanding metal stents in the management of Post sphincterotomy bleeding: a Systematic Review and Meta-analysis.
Gastrointest Endosc
December 2024
Division of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, PA. Electronic address:
Background And Aims: Fully covered self-expandable metallic stents (FCSEMS) are often used in the management of post-sphincterotomy bleeding which is refractory to conventional endoscopic treatments. In this meta-analysis, we have evaluated the efficacy and safety of FCSEMS in the management of post-sphincterotomy bleeding.
Methods: We reviewed several databases from inception to November 6, 2024 to identify studies that evaluated the efficacy, and/or safety of FCSEMS in the management of post sphincterotomy bleeding.
Sphincterotomy with FCSEMS (SPHINX): a monumental answer or the beginning of new mysteries?
Gut
November 2024
Chairman & Chief of Gastroenterology, AIG Hospitals, Hyderabad, Telangana, India.
Endoscopic sphincterotomy to prevent post-ERCP pancreatitis after self-expandable metal stent placement for distal malignant biliary obstruction (SPHINX): a multicentre, randomised controlled trial.
Gut
October 2024
Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.
Article Synopsis
- Endoscopic retrograde cholangiopancreatography (ERCP) with fully covered self-expandable metal stent (FCSEMS) is the main method for biliary drainage in cases of suspected malignant biliary obstruction, but it carries a high risk of post-ERCP pancreatitis (PEP).
- A study aimed to compare the effects of performing an endoscopic sphincterotomy before FCSEMS placement versus not performing it at all on the incidence of PEP.
- The trial included 297 patients and found no significant difference in PEP rates between those who had the sphincterotomy and those who did not, leading to the conclusion that routine sphincterotomy is not necessary before FCSEMS placement
Pancreatic Pseudocyst after Fully Covered Self-expandable Metallic Stent Placement.
Intern Med
November 2024
Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan.
A 70-year-old woman presented with stage III pancreatic head cancer. After endoscopic sphincterotomy, a fully covered self-expandable metallic stent (FCSEMS) was placed in the common bile duct to manage jaundice. The patient developed a fever and abdominal pain 40 days after stent placement, with a suspected diagnosis of infected pancreatic pseudocyst.
View Article and Find Full Text PDFA practical approach to the endoscopic management of biliary strictures after liver transplantation.
Ann Hepatol
March 2024
GI and Liver Unit, Institut de Malalties Digestives, Hospital Clinic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), Barcelona and Ciber de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain. Electronic address:
Biliary tract complications are an important cause of morbidity and mortality after liver transplantation (LT) occurring in 5% to 25% of patients. The most common biliary complication in LT recipients are strictures representing approximately half of these biliary adverse events. Bile duct strictures can be divided into anastomotic biliary strictures (ABS) and non-anastomotic biliary strictures (NABS) depending on their location in the biliary tree, being ABS the most encountered type.
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