Endoscopy 2011; 43(3): 208-216
DOI: 10.1055/s-0030-1256106
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Long-term follow-up after biliary stent placement for postcholecystectomy bile duct strictures: a multicenter study

N.  Tuvignon1 , C.  Liguory2 , T.  Ponchon3 , B.  Meduri4 , J.  Fritsch5 , J.  Sahel6 , J.  Boyer7 , J.  L. Legoux8 , J.  Escourrou9 , C.  Boustiere10 , J.  P.  Arpurt11 , M.  Barthet12 , P.  Tuvignon13 , G.  Bommelaer14 , B.  Ducot15 , F.  Prat1 ,  16
  • 1Gastroenterology Department, Cochin Hospital, Paris, France
  • 2Gastroenterology Department, “Clinique de l’Alma”, Paris, France
  • 3Gastroenterology Department, Edouard Herriot Hospital, Lyon, France
  • 4Gastroenterology Department, “Clinique Bachaumont, Paris, France
  • 5Gastroenterology Department, Kremlin-Bicêtre Hospital, Paris, France
  • 6Gastroenterology Department, Conception Hospital, Marseilles, France
  • 7Gastroenterology Department, St Jean Hospital, Angers, France
  • 8Gastroenterology Department, Source Hospital, Orleans, France
  • 9Gastroenterology Department, Rangueil Hospital, Toulouse, France
  • 10Gastroenterology Department, St Joseph Hospital, Marseilles, France
  • 11Gastroenterology Department, St Marthe Hospital, Avignon, France
  • 12Gastroenterology Department, North Hospital, Marseilles, France
  • 13Gastroenterology Department, Albi Hospital, Albi, France
  • 14Gastroenterology Department, “Hotel Dieu” Hospital, Clermont Ferrand, France
  • 15Inserm U569, Kremlin-Bicêtre Hospital, Paris, France
  • 16Université Paris-Descartes, Paris, France
Further Information

Publication History

submitted 14 April 2009

accepted after revision 6 October 2010

Publication Date:
01 March 2011 (online)

Background and study aims: Endoscopic stenting is a recognized treatment of postcholecystectomy biliary strictures. Large multicenter reports of its long-term efficacy are lacking. Our aim was to analyze the long-term outcomes after stenting in this patient population, based on a large experience from several centers in France.

Methods: Members of the French Society of Digestive Endoscopy were asked to identify patients treated for a common bile duct postcholecystectomy stricture. Patients with successful stenting and follow-up after removal of stent(s) were subsequently included and analyzed. Main outcome measures were long-term success of endoscopic stenting and related predictors for recurrence (after one stenting period) or failure (at the end of follow-up).

Results: A total of 96 patients were eligible for inclusion. The mean number of stents inserted at the same time was 1.9 ± 0.89 (range1 – 4). Stent-related morbidity was 22.9 % (n = 22). The median duration of stenting was 12 months (range 2 – 96 months). After a mean follow-up of 6.4 ± 3.8 years (range 0 – 20.3 years) the overall success rate was 66.7 % (n = 64) after one period of stenting and 82.3 % (n = 79) after additional treatments. The mean time to recurrence was 19.7 ± 36.6 months. The most significant independent predictor of both recurrence and failure was a pathological cholangiography at the time of stent removal.

Conclusion: Endoscopic stenting helps to avoid surgery in more than 80 % of patients bearing postcholecystectomy common bile duct strictures. However, a persistent anomaly on cholangiography at the time of stent removal is a strong predictor of recurrence and may lead to consideration of surgery.

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F. PratMD, PhD 

Department of Gastroenterology
Endoscopy unit
Université Paris-Descartes
Pavillon Achard
Hôpital Cochin

27 rue du Faubourg St Jacques
75014 Paris
France

Fax: +33-1-58411965

Email: frederic.prat@cch.aphp.fr