Biliary Leak in Post-Liver-Transplant Patients Is There Any Place for Metal Stent英文文献资料.docVIP

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Biliary Leak in Post-Liver-Transplant Patients Is There Any Place for Metal Stent英文文献资料.doc

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Biliary Leak in Post-Liver-Transplant Patients Is There Any Place for Metal Stent英文文献资料

HindawiPublishingCorporation HPBSurgery Volume2012,ArticleID684172,7pages doi:10.1155/2012/684172 ResearchArticle BiliaryLeakinPost-Liver-TransplantPatients: IsThereAnyPlaceforMetalStent? FernandaP.Martins, MelissaPhillips, MonicaR.Gaidhane, 1 2 3 TimothySchmitt, andMichelKahaleh 3 4 1 2 3 4 EndoscopyUnit,HospitalIsraelitaAlbertEinstein?aoPaulo,SP,Brazil DepartmentofSurgery,UniversityofTennesseeMedicalCenter,Knoxville,TN37920,USA DivisionofGastroenterologyandHepatology,WeillCornellMedicalCenter,NewYork,NY10021,USA DivisionofGastroenterologyHepatology,DepartmentofSurgery,UniversityofVirginiaHealthSystem, Charlottesville,VA22908,USA CorrespondenceshouldbeaddressedtoMichelKahaleh,mkahaleh@ Received7October2011;Accepted29February2012 AcademicEditor:DanielCasanova Copyright?2012FernandaP.Martinsetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Objectives.Endoscopicmanagementofbileleakafterorthotopiclivertransplant(OLT)iswidelyaccepted.Preliminarystudies demonstratedencouragingresultsforcoveredself-expandablemetalstents(CSEMS)incomplexbileleaks.Methods .Thirty-one patientswithpost-OLTbileleaksunderwentendoscopictemporaryplacementofCSEMS(3partiallyCSEMS,18fullyCSEMSwith ?nsand10fullyCSEMSwith?areends)betweenDecember2003andDecember2010.Long-termclinicalsuccessandsafetywere evaluated.Results.Medianstentindwellingandfollow-upwere89and1,353daysforPCSEMS,102and849forFCSEMSwith?ns and98and203forFCSEMSwith?areends.Clinicalsuccesswasachievedin100%,77.8%,and70%,respectively.Postplacement complications:cholangitis(1)andproximalmigration(1),bothintheFCSEMSwith?ns.Postremovalcomplicationswerebiliary stricturesrequiringdrainage:PCSEMS(1),FCSEMSwith?ns(6)andwith?areends(1).Therewasnosigni?cantdi?erencesin theFCSEMSgroupsregardingclinicalsuccess,age,gender,leaklocation,previoustreatment,stentindwe