AIM:To evaluate the efficacy and safety of endoscopic removal and trimming of self-expandable metallic stents(SEMS).METHODS:All SEMS had been placed for distal biliary strictures.Twenty-seven endoscopic procedures wer...AIM:To evaluate the efficacy and safety of endoscopic removal and trimming of self-expandable metallic stents(SEMS).METHODS:All SEMS had been placed for distal biliary strictures.Twenty-seven endoscopic procedures were performed in 19 patients in whom SEMS(one uncovered and 18 covered) removal had been attempted,and 8 patients in whom stent trimming using argon plasma coagulation(APC) had been attempted at Tokyo Medical University Hospital.The APC settings were:voltage 60-80 W and gas flow at 1.5 L/min.RESULTS:The mean stent indwelling period for all patients in whom stent removal had been attempted was 113.7 ± 77.6 d(range,8-280 d).Of the 19 patients in whom removal of the SEMS had been attempted,the procedure was successful in 14(73.7%) without procedure-related adverse events.The indwelling period in the stent removable group was shorter than that in the unremovable group(94.9 ± 71.5 d vs 166.2 ± 76.2 d,P = 0.08).Stent trimming was successful for all patients with one minor adverse event consisting of self-limited hemorrhage.Trimming time ranged from 11 to 16 min.CONCLUSION:Although further investigations on larger numbers of cases are necessary to accumulate evidence,the present data suggested that stent removal and stent trimming is feasible and effective for stent-related complications.展开更多
文摘AIM:To evaluate the efficacy and safety of endoscopic removal and trimming of self-expandable metallic stents(SEMS).METHODS:All SEMS had been placed for distal biliary strictures.Twenty-seven endoscopic procedures were performed in 19 patients in whom SEMS(one uncovered and 18 covered) removal had been attempted,and 8 patients in whom stent trimming using argon plasma coagulation(APC) had been attempted at Tokyo Medical University Hospital.The APC settings were:voltage 60-80 W and gas flow at 1.5 L/min.RESULTS:The mean stent indwelling period for all patients in whom stent removal had been attempted was 113.7 ± 77.6 d(range,8-280 d).Of the 19 patients in whom removal of the SEMS had been attempted,the procedure was successful in 14(73.7%) without procedure-related adverse events.The indwelling period in the stent removable group was shorter than that in the unremovable group(94.9 ± 71.5 d vs 166.2 ± 76.2 d,P = 0.08).Stent trimming was successful for all patients with one minor adverse event consisting of self-limited hemorrhage.Trimming time ranged from 11 to 16 min.CONCLUSION:Although further investigations on larger numbers of cases are necessary to accumulate evidence,the present data suggested that stent removal and stent trimming is feasible and effective for stent-related complications.
