ERCP-guided plastic vs. metal stents for biliary stricture after liver transplantation: A safety and efficacy...

As liver transplantation (LT) has become a key approach for managing end-stage hepatobiliary diseases, the high incidence of biliary complications, particularly biliary stricture, has emerged as a major challenge affecting the outcomes of liver transplantation. Our aim was to use the large cohort of cases from our center to analyze the safety and efficacy of the different types of biliary stents for biliary stricture after LT.

Retrospective clinical data were collected from 101 patients who underwent ERCP treatment for biliary stricture after LT at the First Affiliated Hospital of Sun Yat-sen University. Patients were divided into two groups: the Multiple Plastic Stents Placement (MPS) group and the Fully Covered Self-Expanding Metal Stents (FCSEMS) group. A comparative analysis was conducted on the preoperative general data, stricture relief rate, stricture recurrence rate, number of ERCP interventions, total duration of stent placement and the incidence of postoperative ERCP- and stent-related complications between the two groups.

There were no significant differences in the baseline characteristics between the two groups. In terms of efficacy, the FCSEMS group required remarkably fewer ERCP interventions to achieve stricture relief, fewer stents, and the markedly shorter total stent placement time. Additionally, the postoperative stricture relief rate in the FCSEMS group was higher than that in the MPS group, the postoperative stricture recurrence rate and stone formation rate in the FCSEMS group were also lower than those in the MPS group. However, these differences between two groups were no significant. No significant differences were observed between the two groups in terms of other complications such as postoperative cholangitis, bleeding, or perforation.

FCSEMS is non-inferior to MPS in terms of complication rates, and offered the practical advantages of fewer ERCP interventions, fewer stents placed, and shorter procedure times.