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01-05-2019 | Original Article

Severe Biliary Stricture Dilation Using the Soehendra Stent Retriever with a Short-Type Balloon Enteroscope in Patients with Surgically Altered Anatomies

Authors: Tadahisa Inoue, Mayu Ibusuki, Rena Kitano, Yuji Kobayashi, Norimitsu Ishii, Tomohiko Ohashi, Yukiomi Nakade, Yoshio Sumida, Kiyoaki Ito, Haruhisa Nakao, Masashi Yoneda

Published in: Journal of Gastrointestinal Surgery | Issue 5/2019

Abstract

Background

Balloon enteroscopy (BE) can be used for endoscopic retrograde cholangiography (ERC) to treat biliary strictures in patients with surgically altered anatomies. However, biliary strictures, including bilioenteric anastomotic strictures, are often very severe and dilation catheters cannot pass through them. The Soehendra stent retriever (SSR) is like a screw drill and can be useful for dilating severe strictures, but the utility of SSR during BE-assisted ERC (BE-ERC) is unclear. This study aimed to examine the efficacy and safety of a dilation technique using the SSR during BE-ERC.

Methods

Between 2014 and 2018, 28 patients with surgically altered gastrointestinal anatomies and severe biliary strictures underwent BE-ERC, and the SSR was used for the dilation procedures. We evaluated the technical success, therapeutic success, and adverse event rates associated with SSR dilation.

Results

The technical success rate was 93% (26/28). The procedures undertaken on two patients with non-anastomotic strictures failed technically because the SSR was not long enough to reach the strictures. The therapeutic success rate was 96% (25/26) for the patients whose procedures were technically successful. The adverse event rate was 7% (2/28), and the adverse events were mild and improved with conservative management. No bleeding or duct perforations occurred.

Conclusions

Although the indications for using the SSR in patients with non-anastomotic strictures should be considered based on the distance between the tip of the scope and the stricture’s location, SSR dilation may be a useful option during BE-ERC if a biliary stricture is very severe.

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Title: Severe Biliary Stricture Dilation Using the Soehendra Stent Retriever with a Short-Type Balloon Enteroscope in Patients with Surgically Altered Anatomies
Authors: Tadahisa Inoue
Mayu Ibusuki
Rena Kitano
Yuji Kobayashi
Norimitsu Ishii
Tomohiko Ohashi
Yukiomi Nakade
Yoshio Sumida
Kiyoaki Ito
Haruhisa Nakao
Masashi Yoneda
Publication date: 01-05-2019
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 5/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-018-3977-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Severe Biliary Stricture Dilation Using the Soehendra Stent Retriever with a Short-Type Balloon Enteroscope in Patients with Surgically Altered Anatomies

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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