Abstract The immune response to cancer is an ongoing area of interest and is the focus of newer systemic agents. Liver-directed therapy has been the standard treatment for primary and metastatic disease limited to the liver. It is increasingly being recognized that these therapies may influence a broader systemic response and immune activation. The clinical and translational data supporting this phenomenon are reviewed herein. The findings and potential impact of the immune response to liver-directed therapies are summarized in this article.
{"title":"Immune Response to Locoregional Therapy","authors":"A. Smolock, S. White","doi":"10.1055/s-0041-1742102","DOIUrl":"https://doi.org/10.1055/s-0041-1742102","url":null,"abstract":"Abstract The immune response to cancer is an ongoing area of interest and is the focus of newer systemic agents. Liver-directed therapy has been the standard treatment for primary and metastatic disease limited to the liver. It is increasingly being recognized that these therapies may influence a broader systemic response and immune activation. The clinical and translational data supporting this phenomenon are reviewed herein. The findings and potential impact of the immune response to liver-directed therapies are summarized in this article.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80287327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Colonoscopy is the gold standard for colorectal cancer (CRC) prevention. The main quality indicator of colonoscopy is the adenoma detection rate, which is inversely associated with the risk of interval CRC and the risk of death from this neoplasia. In the setting of CRC prevention, diagnostic colonoscopy has undergone a remarkable evolution in the past 20 years. Hand in hand with the implementation of CRC prevention programs and technological advances, we are now able to identify tiny and subtle neoplastic lesions and predict their histology with great efficiency. In this article, we briefly review the endoscopy technologies that can be used to improve the detection and characterization of colorectal polyps.
{"title":"Advanced Endoscopic Technologies to Improve the Diagnosis of Colorectal Polyps","authors":"M. Daca Alvarez, L. Rivero-Sánchez, M. Pellisé","doi":"10.1055/s-0041-1740275","DOIUrl":"https://doi.org/10.1055/s-0041-1740275","url":null,"abstract":"Abstract Colonoscopy is the gold standard for colorectal cancer (CRC) prevention. The main quality indicator of colonoscopy is the adenoma detection rate, which is inversely associated with the risk of interval CRC and the risk of death from this neoplasia. In the setting of CRC prevention, diagnostic colonoscopy has undergone a remarkable evolution in the past 20 years. Hand in hand with the implementation of CRC prevention programs and technological advances, we are now able to identify tiny and subtle neoplastic lesions and predict their histology with great efficiency. In this article, we briefly review the endoscopy technologies that can be used to improve the detection and characterization of colorectal polyps.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75823932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Over the last decade, several publications have reported the safety and efficacy of liquid embolics in a wide range of clinical indications. The expansion of clinical scenarios in which liquid embolics are utilized has been in part driven by some of the advantages these materials hold over other embolic agents. For instance, liquid embolics do not rely on the patient's ability to form clot and can be delivered more distally then coils at times. While several liquid embolics are commercially available, and in some cases have been for decades, there are limitations to these materials as well. The potential benefits of liquid embolics combined with the limitations of available materials have led to the ongoing development of several new agents. This review aims to familiarize the reader with both available liquid embolics and those that are relatively new or in development.
{"title":"Liquid Embolics: A Guide to Currently Available and Pipeline Products","authors":"S. Young, A. Gasparetto, J. Golzarian","doi":"10.1055/s-0041-1740266","DOIUrl":"https://doi.org/10.1055/s-0041-1740266","url":null,"abstract":"Abstract Over the last decade, several publications have reported the safety and efficacy of liquid embolics in a wide range of clinical indications. The expansion of clinical scenarios in which liquid embolics are utilized has been in part driven by some of the advantages these materials hold over other embolic agents. For instance, liquid embolics do not rely on the patient's ability to form clot and can be delivered more distally then coils at times. While several liquid embolics are commercially available, and in some cases have been for decades, there are limitations to these materials as well. The potential benefits of liquid embolics combined with the limitations of available materials have led to the ongoing development of several new agents. This review aims to familiarize the reader with both available liquid embolics and those that are relatively new or in development.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87925161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Esophageal varices (EV) are observed in patients with cirrhotic and noncirrhotic portal hypertension. Ectopic varices (ECV) occur outside the esophagogastric region, are less common, and often more challenging to diagnose and effectively manage. The absence of an EV source on endoscopy should raise concern for ECV in patients with significant non-arterial bleeding within the abdomen or gastrointestinal tract. Patient clinical factors including cirrhosis, portal vein thrombosis, and prior abdominal or pelvic surgery warrant an approach for identifying a treatable ECV source. This article offers a descriptive approach to diagnosing and managing ECV in patients with portal hypertension.
{"title":"Ectopic Varices: A Primer","authors":"P. Novelli, P. Orons","doi":"10.1055/s-0042-1747932","DOIUrl":"https://doi.org/10.1055/s-0042-1747932","url":null,"abstract":"Abstract Esophageal varices (EV) are observed in patients with cirrhotic and noncirrhotic portal hypertension. Ectopic varices (ECV) occur outside the esophagogastric region, are less common, and often more challenging to diagnose and effectively manage. The absence of an EV source on endoscopy should raise concern for ECV in patients with significant non-arterial bleeding within the abdomen or gastrointestinal tract. Patient clinical factors including cirrhosis, portal vein thrombosis, and prior abdominal or pelvic surgery warrant an approach for identifying a treatable ECV source. This article offers a descriptive approach to diagnosing and managing ECV in patients with portal hypertension.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"41 1","pages":"152 - 158"},"PeriodicalIF":0.0,"publicationDate":"2021-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84080506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yaqeen Qudah, Juan S. Barajas-Gamboa, Helen H. Sun, Gabriel Díaz Del Gobbo, M. Kroh, R. Corcelles
Abstract The most effective long-term treatment for severe obesity is bariatric surgery with improvement or resolution of obesity-related comorbidities. Single-anastomosis procedures including single-anastomosis duodenoileal bypass and one-anastomosis gastric bypass are relatively new procedures that are gaining popularity worldwide. These surgical techniques are perceived to be less complex with a shorter learning curve in comparison to the standard biliopancreatic diversion with duodenal switch and Roux-en-Y gastric bypass; however, long-term outcomes and complications remain controversial. This article aims to review one-anastomosis procedures, evaluate their outcomes, and review potential complications.
{"title":"Single-Anastomosis Procedures in Metabolic Surgery","authors":"Yaqeen Qudah, Juan S. Barajas-Gamboa, Helen H. Sun, Gabriel Díaz Del Gobbo, M. Kroh, R. Corcelles","doi":"10.1055/s-0041-1736171","DOIUrl":"https://doi.org/10.1055/s-0041-1736171","url":null,"abstract":"Abstract The most effective long-term treatment for severe obesity is bariatric surgery with improvement or resolution of obesity-related comorbidities. Single-anastomosis procedures including single-anastomosis duodenoileal bypass and one-anastomosis gastric bypass are relatively new procedures that are gaining popularity worldwide. These surgical techniques are perceived to be less complex with a shorter learning curve in comparison to the standard biliopancreatic diversion with duodenal switch and Roux-en-Y gastric bypass; however, long-term outcomes and complications remain controversial. This article aims to review one-anastomosis procedures, evaluate their outcomes, and review potential complications.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"178 1","pages":"338 - 345"},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90889694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lizeth Cifuentes, Maria Daniela Hurtado A, Jeanette Eckel-Passow, Andres Acosta
Obesity is a multifactorial disease with a variable and underwhelming weight loss response to current treatment approaches. Precision medicine proposes a new paradigm to improve disease classification based on the premise of human heterogeneity, with the ultimate goal of maximizing treatment effectiveness, tolerability, and safety. Recent advances in high-throughput biochemical assays have contributed to the partial characterization of obesity's pathophysiology, as well as to the understanding of the role that intrinsic and environmental factors, and their interaction, play in its development and progression. These data have led to the development of biological markers that either are being or will be incorporated into strategies to develop personalized lines of treatment for obesity. There are currently many ongoing initiatives aimed at this; however, much needs to be resolved before precision obesity medicine becomes common practice. This review aims to provide a perspective on the currently available data of high-throughput technologies to treat obesity.
{"title":"Precision Medicine for Obesity.","authors":"Lizeth Cifuentes, Maria Daniela Hurtado A, Jeanette Eckel-Passow, Andres Acosta","doi":"10.1055/s-0041-1729945","DOIUrl":"https://doi.org/10.1055/s-0041-1729945","url":null,"abstract":"<p><p>Obesity is a multifactorial disease with a variable and underwhelming weight loss response to current treatment approaches. Precision medicine proposes a new paradigm to improve disease classification based on the premise of human heterogeneity, with the ultimate goal of maximizing treatment effectiveness, tolerability, and safety. Recent advances in high-throughput biochemical assays have contributed to the partial characterization of obesity's pathophysiology, as well as to the understanding of the role that intrinsic and environmental factors, and their interaction, play in its development and progression. These data have led to the development of biological markers that either are being or will be incorporated into strategies to develop personalized lines of treatment for obesity. There are currently many ongoing initiatives aimed at this; however, much needs to be resolved before precision obesity medicine becomes common practice. This review aims to provide a perspective on the currently available data of high-throughput technologies to treat obesity.</p>","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"5 3","pages":"239-248"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1729945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33492406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramiro Cadena-Semanate, Ramón Díaz Jara, A. Guerron, Jin S. Yoo
Abstract Ventral hernia repair (VHR) is among the most frequently performed surgical procedures in the United States. Despite advancements in surgical technique, a significant number of VHR patients experience postoperative complications and hernia recurrence. A key strategy to reduce VHR morbidity is patient optimization before surgery with prehabilitation protocols. Prehabilitation aims to improve patients' functional status with physical conditioning, nutritional intervention, and psychological support. In other surgical disciplines, prompt preoperative action has proven to significantly reduce the negative influence of modifiable comorbidities and accelerate recovery. In this article, we review the literature to assess the applicability and benefits of prehabilitation in elective VHR cases. A review of the available evidence identified obesity, hyperglycemia, and smoking as significant modifiable risk factors that negatively affect VHR outcomes. Prehabilitation has the potential to mitigate and control these comorbidities. Physical conditioning with aerobic, resistance, and inspiratory muscle training is beneficial. Nutritional intervention to control diabetes and in severely malnourished patients is especially important in patients undergoing concomitant gastrointestinal procedures with VHR. Reasonable targets for prehabilitation protocols in elective VHR include a body mass index of 35 kg/m2, HbA1C of 6.5% and tobacco abstinence for at least 4 weeks. Prophylactic measures to minimize the rates of incisional hernia after primary laparotomy repairs include mesh reinforcement and a suture to wound length ratio of at least 4:1.
{"title":"Prehabilitation and Nutrition in Hernia Surgery","authors":"Ramiro Cadena-Semanate, Ramón Díaz Jara, A. Guerron, Jin S. Yoo","doi":"10.1055/s-0041-1733885","DOIUrl":"https://doi.org/10.1055/s-0041-1733885","url":null,"abstract":"Abstract Ventral hernia repair (VHR) is among the most frequently performed surgical procedures in the United States. Despite advancements in surgical technique, a significant number of VHR patients experience postoperative complications and hernia recurrence. A key strategy to reduce VHR morbidity is patient optimization before surgery with prehabilitation protocols. Prehabilitation aims to improve patients' functional status with physical conditioning, nutritional intervention, and psychological support. In other surgical disciplines, prompt preoperative action has proven to significantly reduce the negative influence of modifiable comorbidities and accelerate recovery. In this article, we review the literature to assess the applicability and benefits of prehabilitation in elective VHR cases. A review of the available evidence identified obesity, hyperglycemia, and smoking as significant modifiable risk factors that negatively affect VHR outcomes. Prehabilitation has the potential to mitigate and control these comorbidities. Physical conditioning with aerobic, resistance, and inspiratory muscle training is beneficial. Nutritional intervention to control diabetes and in severely malnourished patients is especially important in patients undergoing concomitant gastrointestinal procedures with VHR. Reasonable targets for prehabilitation protocols in elective VHR include a body mass index of 35 kg/m2, HbA1C of 6.5% and tobacco abstinence for at least 4 weeks. Prophylactic measures to minimize the rates of incisional hernia after primary laparotomy repairs include mesh reinforcement and a suture to wound length ratio of at least 4:1.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"45 1","pages":"260 - 267"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82056555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Tirelli, Paolo Mirco, P. Fransvea, G. Pepe, A. Tringali, M. D. Grezia, C. Lodoli, V. Cozza, A. Greca, G. Sganga
Abstract Endoscopic retrograde cholangiopacreatography (ERCP) has a pivotal role for the management of various malignant and benign pancreatico-biliary disorders. Biliary stents migration is reported in 5 to 10% of the cases and can be responsible for bowel perforation. An 80-year-old Caucasian man was referred to our hospital for an attempt at endoscopic extraction of massive intrahepatic lithiasis; during ERCP, complete stone extraction in a single session was not achievable and three plastic biliary stents were inserted to promote stone size reduction and perform a delayed cholangioscopy-assisted lithotripsy. During the next 2 days, the patient developed worsening abdominal pain with no fever, nausea, and vomiting. An emergency computed tomography showed a duodenal perforation due to biliary stent migration. Upon laparotomy, a direct suture of the duodenal lesion was performed. The patient died 3 days later because of a multiorgan failure. ERCP-related complications may occur in 5 to 15% of the cases and biliary stent migration accounts for 5 to 10% of these cases; less than 1% of stents migration determines bowel perforation, most commonly in the duodenum. Stent-related bowel perforation can be clinically misleading and early diagnosis and treatment are sometimes challenging. Whether the duodenal perforation is intra- or retroperitoneal should be taken into account to choose the best therapeutic approach.
{"title":"Perforation Due to Biliary Stent: Case Report and Review","authors":"F. Tirelli, Paolo Mirco, P. Fransvea, G. Pepe, A. Tringali, M. D. Grezia, C. Lodoli, V. Cozza, A. Greca, G. Sganga","doi":"10.1055/s-0041-1733777","DOIUrl":"https://doi.org/10.1055/s-0041-1733777","url":null,"abstract":"Abstract Endoscopic retrograde cholangiopacreatography (ERCP) has a pivotal role for the management of various malignant and benign pancreatico-biliary disorders. Biliary stents migration is reported in 5 to 10% of the cases and can be responsible for bowel perforation. An 80-year-old Caucasian man was referred to our hospital for an attempt at endoscopic extraction of massive intrahepatic lithiasis; during ERCP, complete stone extraction in a single session was not achievable and three plastic biliary stents were inserted to promote stone size reduction and perform a delayed cholangioscopy-assisted lithotripsy. During the next 2 days, the patient developed worsening abdominal pain with no fever, nausea, and vomiting. An emergency computed tomography showed a duodenal perforation due to biliary stent migration. Upon laparotomy, a direct suture of the duodenal lesion was performed. The patient died 3 days later because of a multiorgan failure. ERCP-related complications may occur in 5 to 15% of the cases and biliary stent migration accounts for 5 to 10% of these cases; less than 1% of stents migration determines bowel perforation, most commonly in the duodenum. Stent-related bowel perforation can be clinically misleading and early diagnosis and treatment are sometimes challenging. Whether the duodenal perforation is intra- or retroperitoneal should be taken into account to choose the best therapeutic approach.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"82 1","pages":"324 - 330"},"PeriodicalIF":0.0,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79957352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shivam Patel, C. DeLong, Luis Jesús Torres Sánchez, N. Goyal, E. Pauli
Abstract Pharyngocutaneous fistula (PCF) is a complication of laryngectomies in 14 to 23% of patients. The rate of spontaneous resolution of small and low-output fistulas has been shown to be 65 to 94% in those who are radiation-naive, with a reduced rate of resolution in patients who were previously radiated as low as 33%. Two patients are presented who underwent total laryngopharyngectomy and anterolateral thigh free flap reconstruction at our institution eventually complicated with PCF. All the pertinent patient data were retrieved through chart review from the records of our institution. The cases presented had a prior history of radiation or chemoradiation complicating the spontaneous resolution of the PCF. Both patients had successful resolution of PCF with the flexible endoscopic techniques presented. This case series highlights the management of small PCFs using flexible endoscopic techniques including over-the-scope clips and Vicryl mesh plugs.
{"title":"The Novel Use of Flexible Endoscopic Techniques in the Management of Pharyngocutaneous Fistulas","authors":"Shivam Patel, C. DeLong, Luis Jesús Torres Sánchez, N. Goyal, E. Pauli","doi":"10.1055/s-0041-1735319","DOIUrl":"https://doi.org/10.1055/s-0041-1735319","url":null,"abstract":"Abstract Pharyngocutaneous fistula (PCF) is a complication of laryngectomies in 14 to 23% of patients. The rate of spontaneous resolution of small and low-output fistulas has been shown to be 65 to 94% in those who are radiation-naive, with a reduced rate of resolution in patients who were previously radiated as low as 33%. Two patients are presented who underwent total laryngopharyngectomy and anterolateral thigh free flap reconstruction at our institution eventually complicated with PCF. All the pertinent patient data were retrieved through chart review from the records of our institution. The cases presented had a prior history of radiation or chemoradiation complicating the spontaneous resolution of the PCF. Both patients had successful resolution of PCF with the flexible endoscopic techniques presented. This case series highlights the management of small PCFs using flexible endoscopic techniques including over-the-scope clips and Vicryl mesh plugs.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"98 1","pages":"319 - 323"},"PeriodicalIF":0.0,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80547205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shaima Abulqasim, M. Arabi, K. Almasar, Bayan A. Albdah, Refaat Salman
Abstract This article aimed to assess the safety and effectiveness of biodegradable stents in the management of benign biliary strictures. This is a retrospective observational study that included all adult patients who had biodegradable stent placement for a benign cause of biliary stricture between July 2016 and August 2019. Nineteen patients were included. Seventeen patients had liver transplant. One patient had hepaticojejunostomy due to primary sclerosing cholangitis and one patient had iatrogenic left main bile duct occlusion. Stents were successfully deployed in all 19 patients (technical success: 100%). Patency rate was 90% (17/19) at 6 months and 80% (12/15) at 12 months. Seven patients in the study had stricture recurrence and needed reintervention with mean time to reintervention of 418 days (range: 8–1,155 days). There was one major complication due to cholangitis and sepsis, which required a treatment course with piperacillin/tazobactam for 10 days. No procedure-related pancreatitis or deaths occurred. Biodegradable stents are a safe and effective treatment option for benign biliary strictures and can achieve long-term patency without the need for reinterventions.
{"title":"Percutaneous Transhepatic Biodegradable Biliary Stent Placement for Benign Biliary Strictures","authors":"Shaima Abulqasim, M. Arabi, K. Almasar, Bayan A. Albdah, Refaat Salman","doi":"10.1055/s-0041-1733796","DOIUrl":"https://doi.org/10.1055/s-0041-1733796","url":null,"abstract":"Abstract This article aimed to assess the safety and effectiveness of biodegradable stents in the management of benign biliary strictures. This is a retrospective observational study that included all adult patients who had biodegradable stent placement for a benign cause of biliary stricture between July 2016 and August 2019. Nineteen patients were included. Seventeen patients had liver transplant. One patient had hepaticojejunostomy due to primary sclerosing cholangitis and one patient had iatrogenic left main bile duct occlusion. Stents were successfully deployed in all 19 patients (technical success: 100%). Patency rate was 90% (17/19) at 6 months and 80% (12/15) at 12 months. Seven patients in the study had stricture recurrence and needed reintervention with mean time to reintervention of 418 days (range: 8–1,155 days). There was one major complication due to cholangitis and sepsis, which required a treatment course with piperacillin/tazobactam for 10 days. No procedure-related pancreatitis or deaths occurred. Biodegradable stents are a safe and effective treatment option for benign biliary strictures and can achieve long-term patency without the need for reinterventions.","PeriodicalId":91014,"journal":{"name":"Digestive disease interventions","volume":"17 1","pages":"307 - 310"},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86643873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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