Temporary FC-SEMS for type II ERCP-related perforations: a case series from two referral centers and review of the literature^*

Abstract

Background and aim: Some case reports have shown that fully covered self-expandable metal stents (FC-SEMS) are effective in cases of Stapfer Type II perforation as rescue treatment. The aim of the study was to assess the efficacy and safety of temporary placement of FC-SEMS as primary treatment for Type II perforations and review the literature regarding the use of FC-SEMS in this setting.

Patients and method: Retrospective analysis of consecutive patients with Type II perforation treated with immediate placement of FC-SEMS. Primary outcomes were need for surgery and mortality rate. Secondary outcomes were complications, technical and clinical success, time to post-operative feeding, length of the hospitalization and time to stent removal.

Results: Overall, 18 consecutive patients were enrolled (median age 71.5). All patients were treated with FC-SEMS (6–10 mm, 4–8 cm long). In all patients, there were no need for surgery, and no patient died. Technical and clinical success were achieved both in 100% of cases. The median time to stent removal was 43 (2–105) days. The median hospital stay was of 10 (4–21) days. Median time to post-operative feeding was 4 days (2–15).

Conclusion: FC-SEMS placement could be a safe and effective treatment in Type II perforations and represent a valuable development and innovation of conservative treatment.

Keywords:

• Endoscopic retrograde cholangiopancreatography
• sphincterotomy
• duodenal retroperitoneal perforation
• fully covered self-expandable metallic stent

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Corrigendum

Acknowledgements

Authors state that this study was not funded.

Disclsoure statement

Dr A Tringali, Dr M Pizzicannella, Dr G Andrisani, Dr M Cintolo, Dr C Hassan, Dr M Mutignani and Dr F Di Matteo have no conflicts of interest or financial ties to disclose. Dr D Adler is a consultant at Boston Scientific.