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Migration of fully covered self-expandable metallic stents used to treat anastomotic strictures after orthotopic liver transplantation: A single-center, retrospective analysis

Insertion of a fully covered self-expandable metallic stent (FCEM) through endoscopic retrograde cholangiopancreatography is an effective solution for biliary anastomotic stricture following orthotopic liver transplantation (OLT). However, FCEM migration continues to plague patients. This study aime...

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Autores principales: Ding, Songming, Wu, Weilin, Lu, Jianfang, Zhu, Hengkai, Zheng, Shusen, Li, Qiyong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797473/
https://www.ncbi.nlm.nih.gov/pubmed/35089220
http://dx.doi.org/10.1097/MD.0000000000028685
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author Ding, Songming
Wu, Weilin
Lu, Jianfang
Zhu, Hengkai
Zheng, Shusen
Li, Qiyong
author_facet Ding, Songming
Wu, Weilin
Lu, Jianfang
Zhu, Hengkai
Zheng, Shusen
Li, Qiyong
author_sort Ding, Songming
collection PubMed
description Insertion of a fully covered self-expandable metallic stent (FCEM) through endoscopic retrograde cholangiopancreatography is an effective solution for biliary anastomotic stricture following orthotopic liver transplantation (OLT). However, FCEM migration continues to plague patients. This study aimed to evaluate the FCEM migration rate in our center, and to investigate the factors increasing the migration risk for FCEM. The study enrolled 43 post-OLT patients with confirmed duct-to-duct AS. The effects of age, gender, albumin, alanine aminotransferase, aspartate aminotransferase (AST), γ-glutamyl transpeptidase, alkaline phosphatase, total bilirubin, direct bilirubin, ABO (blood group system consists of four antigens) incompatibility, stricture length, FCEM brand, FCEM length, donor liver and recipient bile duct diameters, size mismatches between the donor and recipient bile ducts >2 mm, diabetes and/or hypertension status, endoscopic sphincterotomy status, the use of plastic stents or nasobiliary drainage prior to FCEM implantation, duration from OLT to FCEM placement, and OLT etiology on FCEM migration were retrospectively analyzed. The FCEM migration rate was 48.8% (21/43) at 6 months. The serum AST level was significantly higher in the migration group than that in the nonmigration group (52.48 vs 29.50 U/L, P < .05). A lower serum AST level was associated with a decreased risk of FCEM migration in post-OLT patients with duct-to-duct anastomotic stricture (hazard ratio = 0.968, 95% confidence interval: 0.940–0.996, P = .028). In this single-center, retrospective cohort study, we showed that an elevated serum AST level was a potential risk factor for FCEM migration.
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spelling pubmed-87974732022-01-31 Migration of fully covered self-expandable metallic stents used to treat anastomotic strictures after orthotopic liver transplantation: A single-center, retrospective analysis Ding, Songming Wu, Weilin Lu, Jianfang Zhu, Hengkai Zheng, Shusen Li, Qiyong Medicine (Baltimore) 4500 Insertion of a fully covered self-expandable metallic stent (FCEM) through endoscopic retrograde cholangiopancreatography is an effective solution for biliary anastomotic stricture following orthotopic liver transplantation (OLT). However, FCEM migration continues to plague patients. This study aimed to evaluate the FCEM migration rate in our center, and to investigate the factors increasing the migration risk for FCEM. The study enrolled 43 post-OLT patients with confirmed duct-to-duct AS. The effects of age, gender, albumin, alanine aminotransferase, aspartate aminotransferase (AST), γ-glutamyl transpeptidase, alkaline phosphatase, total bilirubin, direct bilirubin, ABO (blood group system consists of four antigens) incompatibility, stricture length, FCEM brand, FCEM length, donor liver and recipient bile duct diameters, size mismatches between the donor and recipient bile ducts >2 mm, diabetes and/or hypertension status, endoscopic sphincterotomy status, the use of plastic stents or nasobiliary drainage prior to FCEM implantation, duration from OLT to FCEM placement, and OLT etiology on FCEM migration were retrospectively analyzed. The FCEM migration rate was 48.8% (21/43) at 6 months. The serum AST level was significantly higher in the migration group than that in the nonmigration group (52.48 vs 29.50 U/L, P < .05). A lower serum AST level was associated with a decreased risk of FCEM migration in post-OLT patients with duct-to-duct anastomotic stricture (hazard ratio = 0.968, 95% confidence interval: 0.940–0.996, P = .028). In this single-center, retrospective cohort study, we showed that an elevated serum AST level was a potential risk factor for FCEM migration. Lippincott Williams & Wilkins 2022-01-28 /pmc/articles/PMC8797473/ /pubmed/35089220 http://dx.doi.org/10.1097/MD.0000000000028685 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle 4500
Ding, Songming
Wu, Weilin
Lu, Jianfang
Zhu, Hengkai
Zheng, Shusen
Li, Qiyong
Migration of fully covered self-expandable metallic stents used to treat anastomotic strictures after orthotopic liver transplantation: A single-center, retrospective analysis
title Migration of fully covered self-expandable metallic stents used to treat anastomotic strictures after orthotopic liver transplantation: A single-center, retrospective analysis
title_full Migration of fully covered self-expandable metallic stents used to treat anastomotic strictures after orthotopic liver transplantation: A single-center, retrospective analysis
title_fullStr Migration of fully covered self-expandable metallic stents used to treat anastomotic strictures after orthotopic liver transplantation: A single-center, retrospective analysis
title_full_unstemmed Migration of fully covered self-expandable metallic stents used to treat anastomotic strictures after orthotopic liver transplantation: A single-center, retrospective analysis
title_short Migration of fully covered self-expandable metallic stents used to treat anastomotic strictures after orthotopic liver transplantation: A single-center, retrospective analysis
title_sort migration of fully covered self-expandable metallic stents used to treat anastomotic strictures after orthotopic liver transplantation: a single-center, retrospective analysis
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797473/
https://www.ncbi.nlm.nih.gov/pubmed/35089220
http://dx.doi.org/10.1097/MD.0000000000028685
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