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Fully covered self-expanding metal stents placed temporarily in the bile duct: safety profile and histologic classification in a porcine model
BACKGROUND: Fully covered Self-Expanding metal stents (FCSEMS) have been shown efficacious in palliating malignant biliary obstructions. There is little data analyzing mucosal response to their temporary placement in the bile duct. METHODS: Ten mini pigs underwent endoscopic placement of a FCSEMS (W...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142530/ https://www.ncbi.nlm.nih.gov/pubmed/21689439 http://dx.doi.org/10.1186/1471-230X-11-76 |
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author | Bakhru, Mihir R Foley, Patricia L Gatesman, Jeremy Schmitt, Timothy Moskaluk, Christopher A Kahaleh, Michel |
author_facet | Bakhru, Mihir R Foley, Patricia L Gatesman, Jeremy Schmitt, Timothy Moskaluk, Christopher A Kahaleh, Michel |
author_sort | Bakhru, Mihir R |
collection | PubMed |
description | BACKGROUND: Fully covered Self-Expanding metal stents (FCSEMS) have been shown efficacious in palliating malignant biliary obstructions. There is little data analyzing mucosal response to their temporary placement in the bile duct. METHODS: Ten mini pigs underwent endoscopic placement of a FCSEMS (Wallflex, Boston Scientific). FCSEMS were kept in place for three months. At the end of the 3 months, FCSEMS were removed endoscopically. Five pigs were euthanized and their bile ducts harvested. The other five were kept alive for another month post removal. A single pathologist, created a scoring system (to determine degree of inflammation, fibrosis, and epithelial injury), examined all specimens in a blinded fashion. RESULTS: Four FCSEMS spontaneously migrated in the duodenum. On post mortem examination, mild mucosal thickness was noted in three bile duct specimens while superficial inflammation of the bile duct was noted in five animals. Histologic examination of the bile duct revealed focal acute inflammation in both groups. For the 5 animals euthanized immediately after stent removal, there was a tendency to have superficial mucosal erosion and fibrosis. In contrast, increased chronic inflammation was more commonly seen in the animals 1 month post stent removal, with all animals in this group showing moderate degrees of mononuclear inflammatory cell mucosal infiltrates. No severe inflammatory or fibrotic duct injury was observed in any of the study animals, with degree of injury graded as mild to moderate. CONCLUSION: FCSEMS appear to induce minimal tissue overgrowth or fibrosis post placement. Ease of removability and no significant histologic injury are advantages noted with FCSEMS., however, further studies are needed to evaluate treating benign biliary strictures with FCSEMS in humans. |
format | Online Article Text |
id | pubmed-3142530 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-31425302011-07-24 Fully covered self-expanding metal stents placed temporarily in the bile duct: safety profile and histologic classification in a porcine model Bakhru, Mihir R Foley, Patricia L Gatesman, Jeremy Schmitt, Timothy Moskaluk, Christopher A Kahaleh, Michel BMC Gastroenterol Research Article BACKGROUND: Fully covered Self-Expanding metal stents (FCSEMS) have been shown efficacious in palliating malignant biliary obstructions. There is little data analyzing mucosal response to their temporary placement in the bile duct. METHODS: Ten mini pigs underwent endoscopic placement of a FCSEMS (Wallflex, Boston Scientific). FCSEMS were kept in place for three months. At the end of the 3 months, FCSEMS were removed endoscopically. Five pigs were euthanized and their bile ducts harvested. The other five were kept alive for another month post removal. A single pathologist, created a scoring system (to determine degree of inflammation, fibrosis, and epithelial injury), examined all specimens in a blinded fashion. RESULTS: Four FCSEMS spontaneously migrated in the duodenum. On post mortem examination, mild mucosal thickness was noted in three bile duct specimens while superficial inflammation of the bile duct was noted in five animals. Histologic examination of the bile duct revealed focal acute inflammation in both groups. For the 5 animals euthanized immediately after stent removal, there was a tendency to have superficial mucosal erosion and fibrosis. In contrast, increased chronic inflammation was more commonly seen in the animals 1 month post stent removal, with all animals in this group showing moderate degrees of mononuclear inflammatory cell mucosal infiltrates. No severe inflammatory or fibrotic duct injury was observed in any of the study animals, with degree of injury graded as mild to moderate. CONCLUSION: FCSEMS appear to induce minimal tissue overgrowth or fibrosis post placement. Ease of removability and no significant histologic injury are advantages noted with FCSEMS., however, further studies are needed to evaluate treating benign biliary strictures with FCSEMS in humans. BioMed Central 2011-06-20 /pmc/articles/PMC3142530/ /pubmed/21689439 http://dx.doi.org/10.1186/1471-230X-11-76 Text en Copyright ©2011 Bakhru et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Bakhru, Mihir R Foley, Patricia L Gatesman, Jeremy Schmitt, Timothy Moskaluk, Christopher A Kahaleh, Michel Fully covered self-expanding metal stents placed temporarily in the bile duct: safety profile and histologic classification in a porcine model |
title | Fully covered self-expanding metal stents placed temporarily in the bile duct: safety profile and histologic classification in a porcine model |
title_full | Fully covered self-expanding metal stents placed temporarily in the bile duct: safety profile and histologic classification in a porcine model |
title_fullStr | Fully covered self-expanding metal stents placed temporarily in the bile duct: safety profile and histologic classification in a porcine model |
title_full_unstemmed | Fully covered self-expanding metal stents placed temporarily in the bile duct: safety profile and histologic classification in a porcine model |
title_short | Fully covered self-expanding metal stents placed temporarily in the bile duct: safety profile and histologic classification in a porcine model |
title_sort | fully covered self-expanding metal stents placed temporarily in the bile duct: safety profile and histologic classification in a porcine model |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142530/ https://www.ncbi.nlm.nih.gov/pubmed/21689439 http://dx.doi.org/10.1186/1471-230X-11-76 |
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