EFFECTIVENESS AND SAFETY OF COVERED SELF-EXPANDING METAL STENT IN BENIGN BILIARY STENOSIS DUE TO CHRONIC PANCREATITIS: OBSERVATIONAL RETROSPECTIVE STUDY

Aims To analyze the technical, clinical success and the complications associated with the placement of cSEMS in benign biliary stenosis secondary to CP in our center.

Methods Retrospective study between January 2012 - December 2018. Epidemiological and analytical variables were analyzed, also data from endoscopic procedure (stent residence time, technical complications, related incidents) and clinical (percentage of recurrences/surgical indications).

Technical success was defined as the correct placement and withdrawal of the cSEMS during the ERCP and clinical success as an analytical improvement (normalization of bilirubin) at 6 months post-withdrawal of the cSEMS.

Stent residence time (patent) was defined as the time in days from stent placement to withdrawal (scheduled, by occlusion/migration or by surgical intervention).

Results 37 cSEMS were included in 20 patients (85% men; mean age 52.55).

The mean basal bilirubin was 5.34mg/dL. In 75% of the patients, cytology and/or stenosis biopsy was performed during ERCP, with no evidence of malignancy. However, in 2 cases the stenosis later turned out to be of malignant etiology.

Technical success was 100% in stent´s placement and removal. There were 25 complications (67.27%), with obstruction and proximal migration being the most frequent complications.

The average residence time of the stent was 305 days. The average bilirubin at 6 months post-stent withdrawal was 1.17mg/dL, achieving clinical success in 70% of cases. 10% required surgical intervention due to recurrence of stenosis.

Conclusions The placement of cSEMS for the treatment of benign biliary stenosis due to chronic pancreatitis is an effective and safe method that can be considered as an alternative to the placement of multiple plastic prostheses.

Our series consists of patients of habitual clinical practice, in which we have observed a clinical success rate of 70%, similar to previous data reported in muticentre trials with clinical success rates between 47-66% in post-withdrawal periods between 3-12 months.