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Title: Metallic vs plastic stents to treat biliary stricture after liver transplantation: a systematic review and meta-analysis based on randomized trials
Authors: VISCONTI, Thiago Arantes de CarvalhoBERNARDO, Wanderley MarquesMOURA, Diogo Turiani HourneauxMOURA, Eduardo Turiani HourneauxGONCALVES, Caio Vinicius TranquilliniFARIAS, Galileu FerreiraGUEDES, Hugo GoncaloRIBEIRO, Igor BragaFRANZINI, Tomazo PrinceLUZ, Gustavo OliveiraSANTOS, Marcos Eduardo dos Lera dosMOURA, Eduardo Guimaraes Hourneaux de
Citation: ENDOSCOPY INTERNATIONAL OPEN, v.6, n.8, p.E914-E923, 2018
Abstract: Background and study aims The first-line approach to anastomotic biliary stricture after orthotopic liver transplantation (OLTX) involves endoscopic retrograde cholangiopancreatography (ERCP). The most widely used technique is placement of multiple plastic stents, but discussions are ongoing on the benefits of fully-covered self-expandable metallic stents (FCEMS) in this situation. This study aimed to compare results from use of plastic and metal stents to treat biliary stricture after transplantation. Patients and methods Searches were performed in the Medline, EMBASE, SciELO/LILACS, and Cochrane databases, and only randomized studies comparing the two techniques were included in the meta-analysis. Results Our study included four randomized clinical trials totaling 205 patients. No difference was observed between the stricture resolution rate (RD: 0.01; 95%CI [-0.08-0.10]), stricture recurrence (RD: 0.13; 95%CI [-0.03-0.28]), and adverse events (RD: -0.10; 95%CI [-0.65-0.44]) between the plastic and metallic stent groups. The metallic stent group demonstrated benefits in relation to the number of ERCPs performed (MD: -1.86; 95%CI [-3.12 to -0.6]), duration of treatment (MD: -105.07; 95%CI [-202.38 to -7.76 days]), number of stents used (MD: -10.633; 95%CI [-20.82 to -0.44]), and cost (average $8,288.50 versus $18,580.00, P <0.001). Conclusions Rates of resolution and recurrence of stricture are similar, whereas the number of ERCPs performed, number of stents used, duration of treatment, and costs were lower in patients treated with FCEMS, which shows that this device is a valid option for initial treatment of post-OLTX biliary stricture.
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Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

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Outros institutos - HC/Outros

Artigos e Materiais de Revistas Científicas - LIM/26
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental

Artigos e Materiais de Revistas Científicas - LIM/35
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo

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