Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/12102
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dc.contributor.authorKaffes, Arthuren
dc.contributor.authorGriffin, Seanen
dc.contributor.authorVaughan, Rhys Ben
dc.contributor.authorJames, Martinen
dc.contributor.authorChua, Teeen
dc.contributor.authorTee, Hoien
dc.contributor.authorDinesen, Lotteen
dc.contributor.authorCorte, Crispinen
dc.contributor.authorGill, Raghubinderen
dc.date.accessioned2015-05-16T01:44:59Z
dc.date.available2015-05-16T01:44:59Z
dc.date.issued2014-03-01en
dc.identifier.citationTherapeutic Advances in Gastroenterology; 7(2): 64-71en
dc.identifier.govdoc24587819en
dc.identifier.otherPUBMEDen
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/12102en
dc.description.abstractPost-liver-transplant biliary anastomotic strictures (ASs) are currently managed with repeated endoscopic retrograde cholangiopancreatographies (ERCPs) inserting multiple plastic stents. Fully covered self-expanding metal stents (FCSEMSs) are being increasingly reported in the management of this condition, however no prospective randomized trials have been performed to date.The aim of this study was to determine whether FCSEMSs decrease overall numbers of ERCPs needed to achieve stricture resolution and to establish the safety, efficacy and cost-effectiveness in this setting.Two tertiary referral centres performed this open-label prospective randomized trial. A total of 32 patients consented and subsequently 20 were randomized with 10 in the FCSEMS arm and 10 in the plastic arm. The FCSEMS arm had the stent in situ for 12 weeks with the plastic stent arm undergoing 3-monthly multiple plastic stenting with or without dilatation over a year.The median number of ERCPs performed per patient in the FCSEMS was 2 versus 4.5 (p = 0.0001) in the plastic stenting arm. Stricture resolution was achieved in all 10 patients with FCSEMSs compared with 8/10 in the plastic arm [p = not significant (NS)]. Complications occurred in 1/10 patients in the FCSEMS arm versus 5/10 in the plastic arm (p = 0.051). Days in hospital for complications was 6 in the FCSEMS versus 56 in the plastic arm (p = 0.11). Cost analysis shows that the FCSEMS arm was more cost effective. No cases of FCSEMS migration were seen.FCSEMSs reduced the number of ERCPs needed to achieve stricture resolution with similar recurrence rates between arms. The FCSEMSs may do so with fewer complications making it cost effective.en
dc.language.isoenen
dc.subject.otherERCPen
dc.subject.otherSEMSen
dc.subject.otherbiliaryen
dc.subject.otherbiliary stricturesen
dc.subject.otherliver transplanten
dc.titleA randomized trial of a fully covered self-expandable metallic stent versus plastic stents in anastomotic biliary strictures after liver transplantation.en
dc.typeJournal Articleen
dc.identifier.journaltitleTherapeutic advances in gastroenterologyen
dc.identifier.affiliationAustin Hospital - Gastroenterology, Victoria, Australiaen
dc.identifier.affiliationWolfson Digestive Disease Biomedical Research Unit - Gastroenterology, Nottingham, UKen
dc.identifier.affiliationRoyal Prince Alfred Hospital - AW Morrow Gastroenterology and Liver Centre, New South Wales, Australiaen
dc.identifier.affiliationRoyal Prince Alfred Hospital - AW Morrow Gastroenterology and Liver Centre, Missenden Road, Camperdown, Sydney, New South Wales 2050, Australiaen
dc.identifier.doi10.1177/1756283X13503614en
dc.description.pages64-71en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/24587819en
dc.type.austinJournal Articleen
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