Endoscopic Bridge-and-Seal of Bile Leaks Using a Fully Covered Self-Expandable Metallic Stent above the Papilla
Background/Aims: Endoscopic management by endoscopic sphincterotomy with or without plastic stents or fully covered self-expandable metallic stents (FCSEMSs) is widely accepted as the current standard of care for postoperative bile leaks. Biliary stents are placed across the papilla, not above the p...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/20/6019 |
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| author | Koshiro Fukuda Yousuke Nakai Suguru Mizuno Tatsuya Sato Kensaku Noguchi Sachiko Kanai Tatsunori Suzuki Ryunosuke Hakuta Kazunaga Ishigaki Kei Saito Tomotaka Saito Naminatsu Takahara Tsuyoshi Hamada Hirofumi Kogure Mitsuhiro Fujishiro |
| author_facet | Koshiro Fukuda Yousuke Nakai Suguru Mizuno Tatsuya Sato Kensaku Noguchi Sachiko Kanai Tatsunori Suzuki Ryunosuke Hakuta Kazunaga Ishigaki Kei Saito Tomotaka Saito Naminatsu Takahara Tsuyoshi Hamada Hirofumi Kogure Mitsuhiro Fujishiro |
| author_sort | Koshiro Fukuda |
| collection | DOAJ |
| description | Background/Aims: Endoscopic management by endoscopic sphincterotomy with or without plastic stents or fully covered self-expandable metallic stents (FCSEMSs) is widely accepted as the current standard of care for postoperative bile leaks. Biliary stents are placed across the papilla, not above the papilla. We investigated the safety and effectiveness of the bridge-and-seal technique for bile leaks by the placement of FCSEMS above the papilla. Methods: This was a retrospective study of FCSEMS placement above the papilla for bile leaks between October 2016 and July 2021. FCSEMS was placed above the papilla to bridge and seal the leak. The main outcome measures were the resolution of bile leaks and adverse events. Results: Seven patients with postoperative bile leaks underwent FCSEMS above the papilla. The locations of bile leaks were 1 cystic duct remnant; 2 intrahepatic bile duct; 1 hepatic duct; 2 common bile duct and 1 anastomosis. The technical success rate of FCSEMS placement was 100%, and resolution of bile leaks was achieved in five patients (71.4%). All the adverse events were observed after FCSEMS removal; as follows: 1 moderate cholangitis; 2 mild post-ERCP pancreatitis; and 1 mild remnant cholecystitis. Conclusions: FCSEMS placement above the papilla can be a treatment option for postoperative bile leaks. |
| first_indexed | 2024-03-09T20:03:10Z |
| format | Article |
| id | doaj.art-b53f62ff770149c48109ea8a9119c223 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T20:03:10Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b53f62ff770149c48109ea8a9119c2232023-11-24T00:39:34ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011120601910.3390/jcm11206019Endoscopic Bridge-and-Seal of Bile Leaks Using a Fully Covered Self-Expandable Metallic Stent above the PapillaKoshiro Fukuda0Yousuke Nakai1Suguru Mizuno2Tatsuya Sato3Kensaku Noguchi4Sachiko Kanai5Tatsunori Suzuki6Ryunosuke Hakuta7Kazunaga Ishigaki8Kei Saito9Tomotaka Saito10Naminatsu Takahara11Tsuyoshi Hamada12Hirofumi Kogure13Mitsuhiro Fujishiro14Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology and Hepatology, Saitama Medical University Hospital, Saitama 350-0495, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology and Hepatology, Nihon University Itabashi Hospital, Tokyo 173-8610, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology and Hepatology, Nihon University Itabashi Hospital, Tokyo 173-8610, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanBackground/Aims: Endoscopic management by endoscopic sphincterotomy with or without plastic stents or fully covered self-expandable metallic stents (FCSEMSs) is widely accepted as the current standard of care for postoperative bile leaks. Biliary stents are placed across the papilla, not above the papilla. We investigated the safety and effectiveness of the bridge-and-seal technique for bile leaks by the placement of FCSEMS above the papilla. Methods: This was a retrospective study of FCSEMS placement above the papilla for bile leaks between October 2016 and July 2021. FCSEMS was placed above the papilla to bridge and seal the leak. The main outcome measures were the resolution of bile leaks and adverse events. Results: Seven patients with postoperative bile leaks underwent FCSEMS above the papilla. The locations of bile leaks were 1 cystic duct remnant; 2 intrahepatic bile duct; 1 hepatic duct; 2 common bile duct and 1 anastomosis. The technical success rate of FCSEMS placement was 100%, and resolution of bile leaks was achieved in five patients (71.4%). All the adverse events were observed after FCSEMS removal; as follows: 1 moderate cholangitis; 2 mild post-ERCP pancreatitis; and 1 mild remnant cholecystitis. Conclusions: FCSEMS placement above the papilla can be a treatment option for postoperative bile leaks.https://www.mdpi.com/2077-0383/11/20/6019postoperative bile leaksbridge and seal techniquefully covered self-expandable metallic stents (FCSEMSs)placement above the papilla |
| spellingShingle | Koshiro Fukuda Yousuke Nakai Suguru Mizuno Tatsuya Sato Kensaku Noguchi Sachiko Kanai Tatsunori Suzuki Ryunosuke Hakuta Kazunaga Ishigaki Kei Saito Tomotaka Saito Naminatsu Takahara Tsuyoshi Hamada Hirofumi Kogure Mitsuhiro Fujishiro Endoscopic Bridge-and-Seal of Bile Leaks Using a Fully Covered Self-Expandable Metallic Stent above the Papilla Journal of Clinical Medicine postoperative bile leaks bridge and seal technique fully covered self-expandable metallic stents (FCSEMSs) placement above the papilla |
| title | Endoscopic Bridge-and-Seal of Bile Leaks Using a Fully Covered Self-Expandable Metallic Stent above the Papilla |
| title_full | Endoscopic Bridge-and-Seal of Bile Leaks Using a Fully Covered Self-Expandable Metallic Stent above the Papilla |
| title_fullStr | Endoscopic Bridge-and-Seal of Bile Leaks Using a Fully Covered Self-Expandable Metallic Stent above the Papilla |
| title_full_unstemmed | Endoscopic Bridge-and-Seal of Bile Leaks Using a Fully Covered Self-Expandable Metallic Stent above the Papilla |
| title_short | Endoscopic Bridge-and-Seal of Bile Leaks Using a Fully Covered Self-Expandable Metallic Stent above the Papilla |
| title_sort | endoscopic bridge and seal of bile leaks using a fully covered self expandable metallic stent above the papilla |
| topic | postoperative bile leaks bridge and seal technique fully covered self-expandable metallic stents (FCSEMSs) placement above the papilla |
| url | https://www.mdpi.com/2077-0383/11/20/6019 |
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