Efficacy and safety of covered metal stents for benign biliary stricture

Aims: To evaluate the efficacy and safety of covered metal stent (CMS) placement for benign biliary stricture (BBS). 
Methods: Between April 2019 to March 2021, patients with BBS who failed initially with plastic stents were evaluated retrospectively. CMS was deployed and then removed 5-9 months later. The primary outcome was clinical success, was defined as the resolution of the stricture of clinical symptoms. Other technical success, adverse events, endoscopic success of stent removal, and recurrence of stricture during the follow-up period were measured.
Results: A total of 26 patients with BBS were received initial endoscopic treatment with plastic stents. Among them, six patients with the failure of initial treatment were placed CMS. CMS placement was technically successful in all patients. During follow-up period, 2 patients showed spontaneous outward migration and recurrence of stricture. The median duration of stent placement except for the 2 patients was 193 days (range, 169-259 days). All patients except for the 2 patients could be removed the stent with success and improved BBS. During a follow-up period after stent removal (median 232 days), only one recurrence developed. One recurrence case, who had BBS due to alcoholic chronic pancreatitis, restarted drinking after stent removal. 
Conclusions: Temporary placement of CMS may be feasible and useful for BBS in patients that primarily failed by plastic stents.