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Histological Changes in the Bile Duct after Long-Term Placement of a Fully Covered Self-Expandable Metal Stent within a Common Bile Duct: A Canine Study.

Lee SS, Song TJ, Joo M, Park do H, Seo DW, Lee SK, Kim MH - Clin Endosc (2014)

Bottom Line: The purpose of this study was to identify the histopathological changes in a bile duct resulting from long-term placement of a FCSEMS.On histopathological examination, mild inflammatory changes were observed in the stented bile ducts, and there was no significant difference between the four groups.An FCSEMS can be inserted into the bile duct without severe histopathological changes up until 9 months.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: To date, it has been difficult to determine the optimal stenting duration of a fully covered self-expandable metal stent (FCSEMS) in a benign biliary stricture. The purpose of this study was to identify the histopathological changes in a bile duct resulting from long-term placement of a FCSEMS.

Methods: An FCSEMS was inserted into the common bile duct of 12 canines, and the animals were divided into four groups. Posteuthanasia, necropsy was performed to examine the histopathological changes in the bile ducts after 1, 3, 6, and 9 months.

Results: The results of necropsy showed that the covered membranes of the FCSEMSs were intact and easily removed from the bile ducts in 11 of the canines. Severe epithelial hyperplasia of the stented bile duct and epithelial ingrowth into the stent occurred in one animal (from the 3-month group). On histopathological examination, mild inflammatory changes were observed in the stented bile ducts, and there was no significant difference between the four groups. Among the 12 animals, five had de novo stricture.

Conclusions: An FCSEMS can be inserted into the bile duct without severe histopathological changes up until 9 months. However, a de novo stricture and severe epithelial hyperplasia relating to the stent insertion might occur.

No MeSH data available.


Related in: MedlinePlus

Macroscopic images of de novo stricture after removal of a fully covered self-expandable metal stent (FCSEMS). (A) De novo stricture occurred at both the proximal (arrows) and distal (arrowheads) portions of the bile ducts after placement of an FCSEMS for 9 months. (B) De novo stricture occurred at the distal portion of the bile duct after placement of an FCSEMS for 6 months (arrows).
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Figure 5: Macroscopic images of de novo stricture after removal of a fully covered self-expandable metal stent (FCSEMS). (A) De novo stricture occurred at both the proximal (arrows) and distal (arrowheads) portions of the bile ducts after placement of an FCSEMS for 9 months. (B) De novo stricture occurred at the distal portion of the bile duct after placement of an FCSEMS for 6 months (arrows).

Mentions: De novo stricture at the proximal or distal end of the stented bile duct was observed in five of the 12 animals (41.6%). These strictures were observed incidentally during necropsy because none of these five animals showed symptoms or signs of bile duct obstruction (Fig. 5).


Histological Changes in the Bile Duct after Long-Term Placement of a Fully Covered Self-Expandable Metal Stent within a Common Bile Duct: A Canine Study.

Lee SS, Song TJ, Joo M, Park do H, Seo DW, Lee SK, Kim MH - Clin Endosc (2014)

Macroscopic images of de novo stricture after removal of a fully covered self-expandable metal stent (FCSEMS). (A) De novo stricture occurred at both the proximal (arrows) and distal (arrowheads) portions of the bile ducts after placement of an FCSEMS for 9 months. (B) De novo stricture occurred at the distal portion of the bile duct after placement of an FCSEMS for 6 months (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928498&req=5

Figure 5: Macroscopic images of de novo stricture after removal of a fully covered self-expandable metal stent (FCSEMS). (A) De novo stricture occurred at both the proximal (arrows) and distal (arrowheads) portions of the bile ducts after placement of an FCSEMS for 9 months. (B) De novo stricture occurred at the distal portion of the bile duct after placement of an FCSEMS for 6 months (arrows).
Mentions: De novo stricture at the proximal or distal end of the stented bile duct was observed in five of the 12 animals (41.6%). These strictures were observed incidentally during necropsy because none of these five animals showed symptoms or signs of bile duct obstruction (Fig. 5).

Bottom Line: The purpose of this study was to identify the histopathological changes in a bile duct resulting from long-term placement of a FCSEMS.On histopathological examination, mild inflammatory changes were observed in the stented bile ducts, and there was no significant difference between the four groups.An FCSEMS can be inserted into the bile duct without severe histopathological changes up until 9 months.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: To date, it has been difficult to determine the optimal stenting duration of a fully covered self-expandable metal stent (FCSEMS) in a benign biliary stricture. The purpose of this study was to identify the histopathological changes in a bile duct resulting from long-term placement of a FCSEMS.

Methods: An FCSEMS was inserted into the common bile duct of 12 canines, and the animals were divided into four groups. Posteuthanasia, necropsy was performed to examine the histopathological changes in the bile ducts after 1, 3, 6, and 9 months.

Results: The results of necropsy showed that the covered membranes of the FCSEMSs were intact and easily removed from the bile ducts in 11 of the canines. Severe epithelial hyperplasia of the stented bile duct and epithelial ingrowth into the stent occurred in one animal (from the 3-month group). On histopathological examination, mild inflammatory changes were observed in the stented bile ducts, and there was no significant difference between the four groups. Among the 12 animals, five had de novo stricture.

Conclusions: An FCSEMS can be inserted into the bile duct without severe histopathological changes up until 9 months. However, a de novo stricture and severe epithelial hyperplasia relating to the stent insertion might occur.

No MeSH data available.


Related in: MedlinePlus