The use of fully covered self-expandable metal stents in the endoscopic treatment of portal cavernoma cholangiopathy

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dc.authorscopusid57200160216
dc.authorscopusid57811192700
dc.authorscopusid7801421151
dc.authorscopusid24178021500
dc.authorscopusid7004103519
dc.authorscopusid58763819900
dc.contributor.authorBuyruk, A.M.
dc.contributor.authorErdoğan, Ç.
dc.contributor.authorTekin, F.
dc.contributor.authorTuran, İ.
dc.contributor.authorÖzütemiz, Ö.
dc.contributor.authorErsöz¹, G.
dc.date.accessioned2024-08-25T18:46:05Z
dc.date.available2024-08-25T18:46:05Z
dc.date.issued2023
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground and aims: There are different therapeutic approaches for biliary strictures and reducing portal hypertension in patients with symptomatic portal cavernoma cholangiopathy (PCC). Endoscopic treatment includes endoscopic biliary sphincterotomy (EST), dilation of stricture with a biliary balloon, placement of plastic stent(s) and stone extraction. Fully covered self-expandable metal stent (FCSEMS) is placed as a rescuer in case of haemobilia seen after EST, dilation of stricture and removal of plastic stent rather than the stricture treatment itself. In this retrospective observational study, we sought to assess the clinical outcomes of FCSEMS as the initial treatment for PCC-related biliary strictures. Materials and methods: Twelve symptomatic patients with PCC both clinically and radiologically between July 2009 and February 2019 were examined. Magnetic resonance cholangiopancreatography (MRCP) and cholangiography were employed as the diagnostic imaging methods. Chandra–Sarin classification was used to distinguish between biliary abnormalities in terms of localization. Llop classification was used to group biliary abnormalities associated with PCC. Endoscopic partial sphincterotomy was performed in all the patients. If patients with dominant strictures 6-8-mm balloon dilation was first performed. This was followed by removal of the stones if exist. Finally, FCSEMS placed. The stents were removed 6–12 weeks later. Results: The mean age of the patients was 40.9 ± 10.3 years, and 91.6% of the patients were male. Majority of the patients (n = 9) were noncirrhotic. Endoscopic retrograde cholangiopancreatography (ERCP) findings showed that 11 of the 12 patients were Chandra Type I and one was Chandra Type IIIa. All the 12 patients were Llop Grade 3. All patients had biliary involvement in the form of strictures. Stent placement was successful in all patients. FCSEMSs were retained for a median period of 45 days (30–60). Seven (58.3%) patients developed acute cholecystitis. There was no occurrence of bleeding or other complications associated with FCSEMS replacement or removal. All patients were asymptomatic during median 3 years (1–10) follow up period. Conclusions: FCSEMS placement is an effective method in biliary strictures in case of PCC. Acute cholecystitis is encountered frequently after FCSEMS, but majority of patients respond to the medical treatment. Patients should be followed in terms of the relapse of biliary strictures. © 2023, The Author(s).en_US
dc.identifier.doi10.1186/s12876-023-03042-5
dc.identifier.issn1471-230X
dc.identifier.issue1en_US
dc.identifier.pmid38017393en_US
dc.identifier.scopus2-s2.0-85178007210en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.urihttps://doi.org/10.1186/s12876-023-03042-5
dc.identifier.urihttps://hdl.handle.net/11454/101795
dc.identifier.volume23en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherBioMed Central Ltden_US
dc.relation.ispartofBMC Gastroenterologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmz20240825_Gen_US
dc.subjectBiliary stricturesen_US
dc.subjectEndoscopic treatmenten_US
dc.subjectFCSEMSen_US
dc.subjectPortal cavernoma cholangiopathyen_US
dc.subjectPortal hypertensive biliopathyen_US
dc.subjectcefotaximeen_US
dc.subjectciprofloxacinen_US
dc.subjectursodeoxycholic aciden_US
dc.subjectabdominal painen_US
dc.subjectacute cholecystitisen_US
dc.subjectadulten_US
dc.subjectantibiotic therapyen_US
dc.subjectArticleen_US
dc.subjectautoimmune hepatitisen_US
dc.subjectballoon dilatationen_US
dc.subjectbile duct diseaseen_US
dc.subjectbile duct fistulaen_US
dc.subjectbiliary tract hemorrhageen_US
dc.subjectcholangiographyen_US
dc.subjectcholestasisen_US
dc.subjectclinical articleen_US
dc.subjectclinical outcomeen_US
dc.subjectcontrolled studyen_US
dc.subjectdisease associationen_US
dc.subjectdisease classificationen_US
dc.subjectdisease severityen_US
dc.subjectendoscopic retrograde cholangiopancreatographyen_US
dc.subjectendoscopic sphincterotomyen_US
dc.subjectendoscopic surgeryen_US
dc.subjectfemaleen_US
dc.subjectfollow upen_US
dc.subjectHepatitis B virusen_US
dc.subjecthumanen_US
dc.subjectjaundiceen_US
dc.subjectmagnetic resonance cholangiopancreatographyen_US
dc.subjectmaleen_US
dc.subjectmiddle ageden_US
dc.subjectnonhumanen_US
dc.subjectobservational studyen_US
dc.subjectportal cavernoma cholangiopathyen_US
dc.subjectportal vein thrombosisen_US
dc.subjectpostoperative infectionen_US
dc.subjectrecurrent diseaseen_US
dc.subjectrelapseen_US
dc.subjectretrospective studyen_US
dc.subjectacute cholecystitisen_US
dc.subjectcholestasisen_US
dc.subjectcomplicationen_US
dc.subjectdiagnostic imagingen_US
dc.subjectstenosis, occlusion and obstructionen_US
dc.subjectstenten_US
dc.subjecttreatment outcomeen_US
dc.subjecttumor recurrenceen_US
dc.subjectAdulten_US
dc.subjectCholangiopancreatography, Endoscopic Retrogradeen_US
dc.subjectCholecystitis, Acuteen_US
dc.subjectCholestasisen_US
dc.subjectConstriction, Pathologicen_US
dc.subjectFemaleen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectNeoplasm Recurrence, Localen_US
dc.subjectRetrospective Studiesen_US
dc.subjectStentsen_US
dc.subjectTreatment Outcomeen_US
dc.titleThe use of fully covered self-expandable metal stents in the endoscopic treatment of portal cavernoma cholangiopathyen_US
dc.typeArticleen_US

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